Skip to main content

Full text of "[Plague, Glasgow, 1900. Sanitary, 1905] [electronic resource]"

See other formats


ACQUIRED  BY 


CORPORATION    OF  Gi.AS'GOW. 


REPORT 

ON  CERTAIN 

CASES  OF  /PLAGUE 

/ 

OCCURRING    IN  GLASGOW, 
/ 

IN  1900, 

BY  THE  MEDICAL  OFFICER  OF  HEALTH. 


PRINTED  BY  ROBERT  ANDERSON,  142  WEST  NILE  STREET,  GLASGOW. 


Digitized  by  tlie  Internet  Archive 

in  2015 


https://archive.org/details/b21359167 


PREFACE. 


The  issue  of  this  Eeport  has  been  delayed  for  the  purpose  of  affording  time  for 
the  completion  of  some  enquiry  which  was  instituted  with  the  view  of  acquiring  a 
more  intimate  Imowledge  of  the  pathology  of  plague,  and  of  the  changes  which 
take  place  in  the  blood  serum  of  the  patient.  With  this  object  the  Report  includes 
a  description  of  the  Symptomatology  and  Sero-therapeutics  by  Dr.  Brownlee, 
Physician-Superintendent,  Belvidere  Hospital;  Dr.  Campbell  M'Clure,  lately 
Senior  Resident  Assistant  Physician,  contributes  a  section  dealing  with  the 
Clinical  Bacteriology ;  Dr.  D.  Louis  Cairns,  who  has  succeeded  him,  undertook 
an  investigation  into  the  agglutinating  properties  of  the  blood  serum,  and 
Dr.  R.  M.  Buchanan,  Bacteriologist  to  the  Corporation,  has  reviewed  the  morbid 
anatomy  and  bacteriology. 

It  is  hoped  that  in  this  way  a  more  complete  picture  of  the  outbreak  will  be 
presented,  and  something  of  permanent  value  added  to  the  technique  of  the 
resources  available  for  the  recognition  of  the  disease. 

A.  K.  CHALMERS,  M.D., 

Medical  Officer  of  Health. 

Sanitary  Chambers, 

Glasgow,  August,  1901. 


CONTENTS. 


Page 


Introduction,  -         -         -         -         -         .         .         .  5 

Former  Plague  Prevalences  in  Britain,    -         -         .         .  6 

Association  and  Topographical  Distribution  of  Cases,    -         -  8 

Types  of  the  Disease  present,        -         -         -         -         -  16 

The  Conditions  of  Spread,    -         -         -         -         -         -  17 

Administrative  Measures,     ------  21 

Venice  Convention,    -------  27 

Protective  Inoculation,  30 

Meteorology,  -         -         -         -         -         -         -         -  31 

Plague  in  Glasgow  in  the  17th  Century,  -         -         -         -  37 

Notes  regarding  Symptomatology,  -         -         -         -         -  39 

Clinical  Histories  of  Cases,           -----  43 

Clinical  Bacteriology,         ------  57 

Sero-therapeutics,     -------  59 

The  Agglutinating  Property  of  the  Blood  Serum,         -         -  62 

Morbid  Anatomy  and  Bacteriology,           -         -         -         -  73 

Microscopical  Examination  of  Fresh  Tissues,       -         -         -  77 

Do.                          DO.            in  Section,           -  78 

Culture  Experiments,   -      -         -         -         -         -         -  81 

Inoculation  Experiments,     -         -          -          -         -         -  82 

Mode  of  Infection,     -         .                   -          -         _         .  83 

Bacteriological  Diagnosis,    -         -         -         -         -          -  84 

Precautions  observed  in  connection  with  Post-mortem  Examina- 
tions AND  Inoculation  Experiments,           -         -         -  85 
Examination  of  Rats,           -          -         -         -         -         -  86 

Illustrations — 

Map  of  Special  Cleansing  Area,  facing       -         -         -  10 

Photographs  of  Buboes,  &c.  Plate  A,  facing  -  -  42 
Charts   showing   Temperature,  Pulse,  and  Respiration 

Rates,  faoing      -         -          -          -         -         -  56 

Illustrations   of   Morbid   Anatomy   and  Bacteriology. 

Plates  I.-V.,  following    -----  86 


INTRODUCTION. 


The  reappearance  of  a  disease  which  had  long  ceased  to  have  any  save  an 
historical  interest  to  the  population  of  Glasgow  is  of  more  than  passing  importance. 

When  Plague  appeared  in  our  midst,  in  the  autumn  of  1900,  it"  abruptly  re- 
opened a  record  in  which  the  last  entry  was  contemporaneous  with  the  period  of 
the  Restoration,  and  of  which  the  pages  of  Defoe  and  Boghurst  may  be  said  to  have 
been  regarded  by  generations  as  the  closing  chapters.^ 

To  some  extent  the  awakening  was  a  rude  one.  In  an  interval  of  two 
centuries  and  a  half  there  is  room  for  much  to  happen  in  the  history  of  a 
population;  but  its  reappearance  has  shown  that  we  have  acquired  no 
racial  immunity  to  plague,  and  that  some  of  the  physical  conditions  necessary 
for  its  development  are  still  present  with  us.  Nor  has  the  disease  changed.  Its 
type  may  be  modified  by  circumstances,  but  it  is  still  capable  with  us  of  manifesting 
a  considerable  degree  of  malignity.  In  our  recent  experience,  in  one  household  of 
two  persons  both  died,  as  did  a  neighbour ;  in  another  of  six  persons,  all  were 
attacked,  and  only  two  recovered. 

Of  the  cases  recognisable  as  plague  during  their  currency  28'5  per  cent, 
proved  fatal,  but  there  were  eight  other  deaths  inferentially  attributable  to  the 
disease,  because  of  their  association  with  subsequent  and  definitely  recognisable 
cases,  which  bring  up  the  number  of  deaths  to  sixteen,  and  the  attacks  to  thirty- 
six. 

There  is  much  to  be  learned  regarding  the  methods  by  which  plague  spreads. 

There  are  many  who  question  whether  it  is  infectious,  or  communicable 
from  man  to  man,  in  the  sense  in  which  measles  is  communicable ;  whether, 
in  fact,  risk  of  contracting  the  disease  arises  from  association  with  the  plague- 
stricken  patient  or  with  an  infected  place.  So  far  as  the  disease  is  an  affection  of 
mankind,  it  would  seem  as  if  infectivity  depended  on  the  tyj)e  which  it  assumes  in 
the  individual  patient.  In  the  limited  experience  which  our  cases  afforded, 
secondary  cases  in  inmates  of  the  same  house,  or  in  visitors,  followed  only  when  the 
original  attack  was  pneumonic  or  diarrhoeal,  or  septicsemic  in  type.  There  was  no 
evidence  that  the  simple  bubonic  form,  even  when  severe  and  treated  for  a 
lengthened  period  at  home,  transmitted  the  disease." 

The  explanation  would  appear  to  be  that  in  these  latter  forms  the  bacillus 
pestis  is  usually  confined  to  the  affected  glands,  and  has  no  means  of  escape  there- 
from until  in  time  it  becomes  degenerate  and  loses  its  virulence,  or  secondary 
suppurative  changes  occur,  which  are  generally  hostile  to  it.^  In  the  pneumonic 
type,  on  the  other  hand,  the  atmosphere  surrounding  the  patient  may  contain 
suspended  particles  of  expectoration,  and  a  true  infectivity  of  the  immediate  neigh- 
bourhood of  the  patient  become  established. 

1  Much  interesting  information  regarding  the  action  of  the  Town  Council  in  plague  years, 
especially  during  the  17th  centurj',  is  contained  in  the  Charters  and  Documents  relating  to  the  City 
of  Glasgow,  1175-1649,  Part  I.,  published  by  Sir  James  Marwick,  and  I  have  to  express  my  indebted- 
ness to  Dr.  William  H.  Hill,  of  Ingram  Street,  for  an  opportunity  of  perusing  many  valuable  MS.  notes 
on  the  condition  of  the  city  and  of  the  customs  of  the  citizens  during  that  period.  A  very  concise 
description  of  the  ravages  of  plague  in  Glasgow  at  that  time,  and  of  the  action  of  the  Town 
Council,  appears  in  the  Memorials  of  the  Faculty  of  Physicians  and  Surgeons  of  Glasgow,  by 
Alexander  Duncan,  Esq.,  LL.D.,  secretary  of  the  Faculty,  ard  extracts  therefrom  will  be  found  on 
p.  37. 

2  There  were  two  apparent  exceptions  to  this — the  secondary  case  at  Oxford  Lane  and  the  tertiary 
attacks  in  Dale  Street.  In  the  former,  association  with  the  wakes  cannot  be  excluded ;  in  the  latter 
there  was  present  in  the  house  in  which  they  contracted  their  infection  the  bed  on  which  a  pneumonic 
patient  had  died. 

3  In  one  case,  however,  the  bacillus  pestis  was  recovered  in  a  virulent  form  from  a  bubo  rupturing 
spontaneously  ;  in  another  it  co-existed  with  putrefactive  bacilli  found  post-niortem  in  a  bubo, 
although  it  was  absent  from  the  discharge  therefrom  during  life. 


6 


But  there  is  another  form  of  plague  prevalence  of  whicli  we  had  no  experi- 
ence. The  disease  affects  both  man  and  some  animals,  and  in  this  resembles 
anthrax,  glanders,  and  tuberculosis.  In  our  recent  experience  it  was  confined  to 
man. 

The  susceptibility  of  rats  to  plague,  and  the  part  played  by  these  animals, 
when  infected,  in  spreading  the  disease,  is  now  well  recognised.  In  the  Formosa 
outbreak  of  1896,  plague  was  known  as  rat  sickness,  and  the  dissemination 
of  the  disease  as  an  affection  of  mankind  in  Sydney,  in  1900,  was  preceded  by 
a  rat  infection.  The  distribution  of  infection  over  wide  areas  is  thus  easily 
accomplished,  although  the  operation  of  still  another  factor  seems  to  be  required 
to  transmit  the  disease  to  man.  It  is  a  laboratory  fact  of  no  mean  significance 
that  cultures  of  the  plague  bacillus  are  notoriously  prone  to  lose  their  virulence. 
In  the  body  of  a  rat  dead  of  plague  the  bacillus  must  find  an  equal  difiiculty 
in  maintaining  it.  But  the  sick  rat  becomes  an  attractive  host  for  fleas,  which 
rapidly  leave  it  when  death  occurs.  These  insects,  together  with  flies,  lice  and  ants, 
are  capable  of  conveying  the  infection,  and  indirect  contact  may  thus  be  established. 
There  is  much  evidence  to  show  that  plague  infection  more  commonly  gains 
access  to  the  system  through  some  injury — it  may  be  a  trifling  one — to  the  skin 
or  mucous  membrane ;  there  is  little  in  favour  of  it  ever  being  acquired  through 
food.  If  the  bite  of  an  insect,  acting  as  the  temporary  host  of  the  bacillus  of  plague, 
inoculates  the  disease  through  the  puncture,  after  the  manner  in  which  the 
malarial  parasite  is  transmitted  through  the  bite  of  certain  mosquitoes,  the  locality 
of  infection  and  contact  therewith  both  acquire  an  elastic  meaning.  It  has  been 
shown  that  from  the  rat-infected  flea  the  bacillus  may  be  recovered;  although 
experiments  are  awanting  to  show  how  long  it  may  remain  virulent  in  the  insect.^ 

In  the  cases  which  came  under  observation  there  was  a  definite  grouping  of 
those  directly  associated  with  the  neighbourhood  of  "  wakes,"  and  there  were 
•certain  others  which  had  no  such  association.  Taken  by  themselves,  these  latter 
were  but  broken  links  in  a  chain,  having  in  common  only  the  fact  that  they  were 
plague-stricken.  But  in  two  instances  antecedent  deaths  had  occurred,  one,  at 
least,  of  these  being  a  visitor  to  a  tenement  in  which  it  is  now  reasonably  certain 
that  the  septicsemic  form  of  the  disease  had  caused  one  death,  and  in  which  one 
if  not  two  others  were,  at  the  time,  sick  of  attacks  that  were  to  prove  fatal  sub- 
sequently. In  two  more,  contact  with  the  wakes,  in  the  intermediate  sense 
already  alluded  to,  could  be  established ;  and  in  the  remaining  case,  the  wife  of 
an  employe  of  the  department  had  the  infection  conveyed  to  her  in  her 
husband's  clothing,  though  their  home  was  far  removed  from  the  area  of  infection. 

By  placing  the  unrecognised  deaths  at  home  in  the  series  of  attacks,  the 
continuity  of  the  series  becomes  established,  and  the  agency  by  which  the  disease 
was  transmitted  to  the  clothes  collector's  wife  suggests  the  medium  by  which 
"  contact "  for  the  apparently  disconnected  cases  may  have  been  established. 

Plague  Pandemic  from  13th  to  17th  Centuries — Its  Former  Prevalence 

IN  Britain. 

It  may  be  of  some  general  interest  here  rapidly  to  outline  the  scope  of  the 
former  prevalences  of  plague  in  this  country. 

To  many  the  Great  Plague  of  London  stands  as  an  incident  by  itself,  quite  un- 
associated  historically  with  any  other  event  save  the  Great  Fire  which  followed  it ; 
and  when  plague  ceased  after  the  fire  had  occurred,  the  theory  that  there  was 
no  more  plague  because  the  fire  had  destroyed  the  places  where  plague  had  found 
a  home  was  too  obviously  a  deduction  from  the  facts  to  be  doubted — for  a  time,  at 
least. 


^  The  part  plaj'ed  by  the  flea  in  the  propasration  of  the  disease  among  rats  is  so  important  that  I 
have  introduced,  on  p.  30,  an  extract  from  a  report  by  Dr.  Tidswell,  which  accompanies  that  of  the 
Chief  Medical  Officer  (Dr.  Ashburton  Tliompson)  on  the  recent  outbreak  at  Sydney. 


7 


But  in  Marseilles,  about  sixty  years  afterwards,  and  in  Moscow,  in  1770,  out- 
breaks of  the  disease  occurred  with  a  virulence  almost  equal  to  that  which  made 
the  Great  Plague  historical,  and  with  it  they  form  the  major  incidents  in  the 
recession  of  a  pandemic  which  lasted  for  more  than  four  centuries  and  had 
included  the  whole  of  Europe  in  its  ravages. 

It  is  necessary  to  recall  this  in  order  to  appreciate  what  underlies  the  phrase, 
again  so  common  in  recent  years,  in  describing  the  present  diffusion  of  plague,  for 
there  is  a  suggestiveness  in  the  widely  extended  cyclical  movements  of  this  disease 
which  raises  It  above  the  category  of  those  which  are  wholly  dependent  on  local 
causes.  On  two  former  occasions,  at  least,  plague  extended  to  Britain.  The 
Justinian  outbreak,  which  devastated  Europe  in  the  sixth  century,  appeared  in 
Britain  in  that  which  followed,  and  the  Black  Death,  of  the  fourteenth  century, 
were  both  examples  of  a  Western  diffusion  of  plague,  which  reached  Europe  in  the 
former  instance  through  Egypt,  and  in  the  latter  came  overland  from  China.  But 
while  the  Justinian  Plague  appears  to  have  exhausted  its  malignancy  in  Britain  in 
twenty  years  (664-685),  the  Black  Death  left  its  impression  on  our  epidemic  history 
for  three  centuries,  until,  indeed,  its  final  extinction  some  fourteen  years  after  the 
occurrence  of  the  Great  Plague  in  London  in  1665.^ 

During  the  centuries  which  lay  between  the  appearance  of  the  Black  Death 
and  the  occurrence  of  the  Great  Plague,  the  disease  was  endemic  in  Britain — ■ 
tending  latterly  to  linger  among  the  population  of  towns,  having  a  certain 
periodicity  in  the  times  of  its  maximum  prevalences,  and  almost  capriciously 
capable,  as  in  the  great  outbreaks  in  London,  Marseilles,  and  Moscow,  of  displaying 
the  malignity  which  three  centuries  earlier  had  earned  for  it  the  name  of  the 
Black  Death. 

Following  its  extinction  in  this  country,  it  was  wholly  absent  from  Western 
Europe  during  the  greater  part  of  the  eighteenth  century,  and  its  further  recession 
may  be  told  in  a  quotation  from  Mr.  Netten  Radcliffe  : — At  the  close  of  the  first 
third  of  the  nineteenth  century  the  area  of  the  prevalence  of  the  disease  had 
shrunk  to  the  easternmost  parts  of  the  Turkish  Empire  in  Europe,  and  in  the  year 
1841  plague  ceased  on  the  Continent  altogether." 

Almost  simultaneously  it  had  been  receding  along  the  Southern  shores  of  the 
Mediterranean,  and  its  disappearance  from  Syria,  Asia  Minor,  and  Egypt,  in  1844, 
encouraged  the  hope  that  a  disease  which  had  left  its  impress  on  the  epidemiology 
of  five  centuries  had  been  extinguished  in  the  struggle  which  mankind  is  ever 
waging  with  the  uncontrolled  forces  of  nature. 

It  is  from  this  point  that  the  increasing  prevalence  of  plague  in  recent  years 
must  be  measured,  for  although  the  Hong  Kong  outbreak  of  six  years  ago  stands 
almost  at  the  beginning  of  a  new  era  of  wide  distribution,  the  importance  of  this,  as 
a  factor  in  its  distribution,  is  limited  to  the  facilities  for  transit  which  the  commerce 
of  Hong  Kong  placed  at  its  disposal.  Indeed,  the  distribution  of  plague  and  its 
diffusion  may  convey  quite  distinct  conceptions,  for  at  the  present  moment  plague 
is  more  widely  distributed  than  ever,  whilst  we  are  still  slowly  accumulating 
evidences  of  its  diffusion.  For  this,  modern  methods  of  commerce  and  travel  are 
responsible.  In  transit  by  land,  epidemics  diffused  themselves  along  a  caravan 
route.  The  furthest  point  reached  was  but  a  step  beyond  the  previous  resting 
place,  and  lateral  diffusion  along  the  route  was  possible.  The  Black  Death  reached 
Europe  in  less  than  half  a  century  after  its  probable  origin  in  China,  but  the  way 


1  When  the  Black  Death  appeared  in  Britain,  Europe  had  barely  awakened  from  the  sleep  of  the 
Middle  Ages.  It  began  in  Dorsetshire  about  August,  1348,  reached  London  in  the  end  of  that  year, 
and  in  January,  1349,  Parliament  was  prorogued  "owing  to  the  increasing  severity,  day  by  day,  at 
Westminster  and  places  adjoining."  Spreading  northward  it  entered  Scotland  in  the  autumn  of  1349, 
appearing  first  among  "  the  Scots  assembled  in  the  Forest  of  Selkirk  for  an  invasion,  at  the  time  when 
the  mortality  was  greatest  in  the  Northern  Counties  of  England,  but  was  held  in  check  there 
during  the  winter  months  following.  Its  former  prevalence  in  Glasgow  came  to  an  end  about 
the  year  1648.1 

1  See  "  History  of  Epidemics  in  Britair,"  by  C.  Creighton,  M  D.    University  Press,  Cambridge,  1S91. 


8 


thither  was  marked  by  its  ravages.  Now,  in  less  than  six  years,  both  hemispheres 
have  been  invaded,  although  this  alone  is  an  illustration  of  the  method  of  distribu- 
tion rather  than  evidence  of  pandemic  intensity.  For  this  latter  we  must  look  to 
the  Eastern  haunts  of  plague,  and  there  the  evidences  are  sufficiently  disturbing. 
For  while  there  is  now  some  reason  to  doubt  the  reality  of  its  disappearance  in  the 
middle  of  the  nineteenth  century,  its  movement  in  the  latter  half  has  been  towards 
an  ever-widening  area  of  prevalence,  and  the  century  closes  while  the  avenues  of 
commerce  are  being  watched  for  its  appearance  with  a  minuteness  probably  quite 
unparalleled.  For  plague  is  an  international  question,  and  commerce  vibrates  with 
every  evidence  of  its  progress. 


ASSOCIATION  AND  TOPOGRAPHICAL  DISTRIBUTION  OF  CASES. 

Written  after  the  events  described  have  terminated,  it  has  been  possible 
here  to  deal  with  the  outbreak  as  a  continuous  narrative,  and  to  discuss  many  of 
the  questions  which  the  association  of  cases  suggested,  but  it  has  been  deemed 
advisable  also  to  append  the  Interim  Reports  presented  to  the  Health  Committee 
during  the  successive  fortnights  in  which  plague  was  present,  as  these  best 
convey  the  impression  created  by  the  events  while  still  in  their  development. 

When  plague  was  recognised  to  exist,  it  had  already  invaded  several  families, 
and  had  been  present  for  at  least  a  fortnight,  almost  certainly  for  three  weeks. 
It  was  suspected  to  exist  on  25th  August.  On  the  27th,  a  man  was  found 
who  had  sickened  on  the  12th,  while  his  wife  was  already  dead  on  the  9th,  and  a 
grandchild,  a  baby  of  two  months,  living  with  them,  on  the  7th  of  that  month. 

The  circumstances  attending  the  recognition  of  the  disease,  as  related  in  my 
Report  to  the  Health  Committee  on  10th  September,  1900,  are  as  follows: — • 

A  child  and  its  grandmother  (Mrs.  B. ),  livhig  in  the  sa,me  liouse  at  71  Rose  Street,  South-Side, 
Glasgow,  sickened  suddenly'  on  the  evening  of  3rd  August — the  child  dying  on  the  7th  and  the 
grandmother  on  the  9th — the  cause  of  death  of  the  child  being  certified  as  "zymotic  enteritis,'' 
and  of  the  grandmother  "acute  gastro-enteritis."  In  both  cases  a  wake  was  held,  and  the  grand- 
mother was  buried  on  the  11th.  Although  the  husband  of  this  latter  patient  sickened  on  the  12th, 
he  was  only  admitted  to  hospital  on  Monday,  27th  August,  certified  "enteric  fever,"  when  he 
was  recognised  to  be  suffering  from  plague. 

Concurrently  with  the  later  developments  in  this  household,  the  following  illnesses  were 
appearing  in  the  members  of  a  family  (M.),  57  Thistle  Street,  some  of  whom  had  either  attended 
Mrs.  B.  's  wake,  or  were  present  during  the  illnesses  in  her  house. 

On  the  evening  of  Sunday,  19th  August,  a  child,  Christina  M.,  10  years,  sickened  with  acute 
symptoms,  which  ended  fatally  at  mid-day  on  the  21st.  She  was  only  medically  visited,  however, 
within  ten  minutes  of  her  death.  The  symptoms  were  those  of  pneumonia,  and  the  cause  of  death 
was  certified  as  "acute  pneumonia." 

Before  the  child  died  the  mother  had  already  sickened  (20th) ;  a  son  (since  dead)  sickened  on 
the  22nd,  and  a  half-brother,  a  young  child  of  three  years,  sickened  on  Thursday,  23rd.  ^  These 
three  were  first  seen  by  Dr.  C.  E.  Robertson,  who  had  also  seen  the  child  Christina,  and  later  by 
Dr.  Colvin,  who,  on  discovering  that  Dr.  Robertson  had  already  visited,  went  to  confer  with  him 
regarding  the  symptoms.  The  action  in  which  this  conversation  ended  is  thus  described  by  Dr. 
Robertson  : — 

' '  We  were  satisfied  that  they  were  cases  demanding  the  attention  of  the  Sanitary  Authorities, 
and  I  agreed  with  Dr.  Colvin  that,  having  both  seen  them  independently,  we  should  both  notify 
them  as  cases  of  enteric  fever,  with  a  mark  of  interrogation  after  it,  to  imply  that  the  diagnosis 
was  not  definite,  but  that  they  were  evidently  of  an  infectious  nature,  and  should  be  removed 
at  once. " 

They  were  accordingly  notified  on  25th  August,  and  removed  to  hospital  same  day. 

On  admission.  Dr.  Brownlee,  the  Physician-Superintendent,  made  a  careful  examination  of  the 
cases,  which  resulted  in  his  coming  to  the  conclusion  that  the  patients  were  suffering  from  bubonic 
plague,  although  they  were  inhabitants  of  Glasgow,  and  there  was  no  known  case  of  bubonic 
plague  in  Britain.     Dr.  Weir,  Senior  Assistant  Physician  at  the  Hospital,  and  Dr.  Knight,  my 


'  On  sutsequent  enquiry  it  was  found  that  this  patient  sickened  on  22nd. 


9 


assistant,  concurred  in  the  diagnosis.  Dr.  M'Cliire,  Acting  Sivperintendent  of  the  Smallpox 
Hospital,  immediately  examined  blood-films  obtained  by  hypodermic  puncture  of  the  buboes,  with 
the  result  that  typical  forms  of  the  bacillus  pestis  were  observed.  Immediately  on  this  conclusion 
being  arrived  at,  Dr.  Knight  visited  the  patient's  house,  verified  the  story  of  the  illness  and  death, 
and  arranged  for  the  removal  of  the  other  members  of  the  family  to  the  reception-house  for 
observation.  Cultures  taken  on  glycerine  agar  showed,  by  the  evening  of  August  26th  and  the 
morning  of  August  27th,  the  typical  appearance,  both  macroscoj)ical  and  micioscopical,  of  the 
bacillus  pestis.  Later  in  the  week  they  wore  fully  confirmed  by  animal  experiments  by  Dr.  Muir, 
Professor  of  Pathology  in  the  University  of  Glasgow,  in  the  absence  of  our  own  Bacteriologist, 
Dr.  R.  M.  Buchanan.    (Professor  Muir's  Report  will  be  found  at  p.  28.) 

On  the  same  day  that  these  three  cases  were  admitted  (25th  August),  another  woman  (Mrs.  T., 
23  Oxford  Lane),  had  been  admitted  certified  typhus  fever.  This  disease  was  excluded  on 
examination,  and  owing  to  the  presence  of  an  inflammatory  condition  in  the  left  groin,  and  a  history 
of  recent  confinement,  the  provision.al  diagnosis  of  pelvic  cellulitis  was  entertained.  Later,  her 
association  witli  the  B.  family  was  discovered,  and  the  diagnosis  revised  in  the  light  of  the  symptoms 
presented  by  these  others. 

The  house  occupied  by  the  B.  family  was  a  single  apartment  on  the  ground 
floor.  It  is  distant  at  least  a  quarter  of  a  mile  from  the  river^ — considerably 
further  from  the  docks.  The  father,  although  a  dock  labourer,  was  employed 
exclusively  in  vessels  engaged  in  the  coasting  trade,  and  no  evidence  of  other 
association  with  shipping  could  be  found.  The  mother  was  a  fish  hawker,  and  took 
special  charge  of  her  grandchild.  This  is  important,  because  the  grandmother  took 
the  child  with  her  wherever  she  went,  and  they  sickened  simultaneously.  It 
suggests  that  they  found  their  infection  beyond  the  limits  of  their  dwelling.  On 
the  other  hand,  the  child's  grandfather,  the  dock  worker,  sickened  on  the  day 
following  his  wife's  burial.  The  only  other  inmate  of  this  house  was  a  daughter — 
mother  of  the  baby  referred  to — and  employed,  until  the  date  of  her  mother's 
sickening,  in  a  rag  store.    She  was  not  affected. 

In  tracing  the  spread  of  the  infection  from  this  focus,  a  passing  reference 
is  necessary  to  the  social  customs  of  the  class  to  which  these  persons  belonged 
when  death  occurs,  because  here,  as  on  a  subsequent  occasion  of  a  similar 
character  in  Thistle  Street,  they  played  an  important  part  not  only  in  the  spread 
of  the  disease,  but  in  rendering  its  recognition  easier. 

Waking,  or  watching  with  the  dead,  is  primarily  an  act  of  reverence  and  of 
sympathy.  But  "  wakes,"  as  we  now  mostly  know  them,  are  an  abuse  of  this 
custom.  They  are  lacking  absolutely  in  reverence,  and  only  a  distorted  conception 
of  friendship  could  construe  them  into  expressions  of  sympathy.  Hospitality  is, 
perhaps,  natural  in  the  circumstances,  but  its  excess  becomes  debauchery,  and  when, 
to  this,  indulgence  in  games  is  added,  the  last  remnant  of  reasonableness  in  the 
custom  has  gone.  This  digression  is  necessary  for  the  purpose  of  explaining  how 
gross  but  temporary  overcrowding  occurred  in  the  infected  houses,  and  became  a 
powerful  factor  in  the  spreading  of  the  disease.  Considerably  over  one  hundred 
persons  were  present  on  one  or  other  of  the  evenings  on  which  these  ceremonies 
were  held,  and,  as  the  families  were  related,  many  attended  the  "  Avakes  "  in  both 
households.  On  the  first  occasion,  the  "  wakes "  were  held  during  the  evenings 
from  7th  to  10th  August,  and  among  those  present  were  several  members  of  a 
family,  M.,  residing  at  57  Thistle  Street.  Four  of  these  latter  ultimately  Avere 
affected,  but  two  only,  I  think,  need  be  regarded  as  contracting  their  infection  at 
71  Rose  Street.  The  first  victim  in  this  second  family,  a  child  (T.  M.),  sickened  on 
19th  August,  nine  days  after  the  last  evening  of  the  first  "  wake."  Her  mother 
sickened  on  the  following  day,  and  two  brothers  on  the  22nd.  This  child  died  on 
the  21st,  and  here,  again,  on  that  evening,  and  on  the  22nd,  there  occurred  a 
repetition  of  the  ceremonies  Avhich  had  taken  place  from  the  7th  to  the  10th  in 
the  Rose  Street  house.  The  first  illness  in  the  Thistle  Street  house  was 
pneumonic  in  tjqoe,  and  the  two  members  of  this  household,  sickening  on  the  22nd, 


1  A  reference  to  the  accompanying  map  will  help  the  reader  unacquainted  with  the  locality  to 
follow  the  distribution  of  the  cases. 


10 


most  probably  obtained  their  infection  from  her.  Subsequently  to  these  "  wakes," 
the  following  attacks  occurred : — 

( 1 )  Attacks  in  Persons  visiting  Rose  Street  House. 

Three  households  were  primarily  infected,  and  five  persons  sickened  secondarily 
to  them. 

Primary.  Secondary. 

(1)  23  Oxford  Lane,  -       -    T.,  Sickened,  12th  Aug.         21st  Aug. 

(2)  57  Thi.ae  Street,     '   ■    M.,       ,.     1^^  f^^^ 

(3)  248  Ma,thieaon  Street,  -   0.,/^'°"'™'"'  <'>         ^°8-      ^-  <'> 

iDiscovered     1st  Sept.      H.,  7th  Sept. 

The  date  here  assigned  to  the  primary  attack  at  Mathieson  Street  is  subject 
to  an  explanation.  This  patient  was  a  daily  visitor  to  a  non-infected  house  at  71 
Rose  Street,  for  the  purpose  of  tending  a  child  during  the  mother's  absence  at 
work,  and  is  known  to  have  been  present  in  the  infected  house  during  the  funeral 
service  on  11th  August,  and  may  have  visited  later  during  the  husband's  illness, 
but  of  this  we  have  no  reliable  information.  Her  visits  ended  on  21st  August, 
and  on  the  24th  she  was  seriously  ill,  according  to  the  mother  of  the  child  she 
nursed.  At  this  time  her  daughter,  who  is  indicated  on  the  list  of  secondary 
cases  by  D.  (?),  was  well.  It  is  only  on  1st  September  that  the  mother's  illness 
was  known  to  us,  and  her  daughter  was  at  the  same  time  found  dead,  and 
decomposition  was  too  far  advanced  to  admit  of  a  post-mortem  examination  being 
made. 

The  other  secondary  case  at  Mathieson  Street  was  a  neighbour  and  visitor 
of  the  family  G. 

(2)  Attacks  in  Persons  visiting  Thistle  Street  House. 
Six  persons  were  infected,  and  there  were  no  secondary  cases. 
■        (1)  6  South  Coburg  Street,          -  T.H.,    Sickened,    23rd  Aug. 

(2)  57  Thistle  Street,        -        -M'K,         „  28th 

(3)  110  South  Wellington  Street,  M., 

(4)  28  Cook  Street,     -       -       -  D., 

(5)  57  Thistle  Street,  -       -       -  M'G., 

(6)  „  ...       -  K, 

The  first  patient  on  this  list  probably  owes  his  infection  to  visits  to  the 
Thistle  Street  household  during  the  currency  of  the  child's  illness,  rather  than  to 
attendance  at  her  "  wake,"  because  he  sickened  on  the  day  following  her  death. 
This  Thistle  Street  house  consisted  of  two  apartments  on  the  first  floor  (1  up,  that 
is),  "  ticketed    for  four,  but  occupied  at  the  time  by  eight  adults  and  one  child. 

Leaving  aside  these  groups  for  the  moment,  there  are  others  which  require 
consideration,  because  their  association  with  the  "  wake "  households  was  in  no 
case  direct,  in  some  it  was  hypothetical,  and  in  others  there  was  no  evidence  that 
it  existed. 

(3)  Attacks  in  other  Persons  associated  ivith  Pose  Street. 

vSickened.  Removed  to  Hospital. 

77  Rose  Street,  -       -       -    P.  F.,        13th  August.  29th  August. 

1  Well  Street,     -       -       -    J.  C,        17th     „  30th  „ 

P.  F.,  a  jobbing  shoemaker,  lived  next  land  but  one  to  the  family  first 
attacked,  but  was  not  a  visitor,  nor  with  any  knowledge  of  having  repaired  boots 
for  the  affected  household  at  the  time. 

J.  C.  was  a  frequent  visitor  to  the  house  next  door  to  the  infected  one,  and 
occasionally  stayed  over  night  there,  but  denied  having  been  present  in  this  latter. 
His  house  was  on  the  other  side  of  the  river. 


28th  „  ) 

'^9th  (  ^i^-'^^'^^d  in 

30th  "  }  Reception- 

31st  „ 


1  By  Section  378  of  the  Glasgow  Police  Act,  1866,  any  bouse  of  not  more  than  three 
apartments,  wliose  cnbio  contents  do  not  exceed  2,000  feet,  may  be  examined  and  ticketed  to  indicate 
the  number  of  persons  it  may  legally  accommodate.  The  standard  of  accommodation  was  raised  to 
400  cubic  feet  for  adults  by  the  Amending  Act  of  1890. 


11 


(J^.)  Attacks  in  Persons  indirectly  or  donhtfully  associated  wiJ,h  "  Wake"  Households. 

(a)  15.!^  Crookston  Street — 
M.  M'L.,  a  child  of  18  months,  sickened  on  20th  August,  but  suspicion 
regarding  the  nature  of  the  illness  was  only  aroused  when  the  cases  at  Thistle 
Street  were  recognised.  Consequently,  she  was  nursed  at  home  till  6th  September. 
A  girl  who  had  been  present  at  the  Rose  Street  "  wake,"  and  was  employed  along 
with  the  patient  R.  M.  (10),  in  a  hair  factory,  but  was  herself  unaffected,  lived  next 
door  to  this  child,  and  occasionally  nursed  her. 

(b)  57  South  Coburg  Street — 
Four  cases  sickened  here  between  13th  and  14th  September.  A  fatal  illness 
of  six  days'  duration  had  commenced  on  22nd  August  in  this  house,  which  was 
regarded  at  the  time  as  pneumonia,  but  had  been  accompanied,  according  to 
information  obtained  subsequently  from  the  friends,  by  painful  swellings  in 
the  neck  and  axilla.  This  earlier  illness  should,  I  think,  be  regarded  as  plague, 
and  the  subsequent  illnesses  occurring  in  this  household  as  due  to  the  continuance 
therein  of  infection. 

(c)  23  Florence  Street — 
R.  M.  sickened  here  on  23rd  August,  but  the  nature  of  her  illness  was 
not  suspected  till  10th  September,  when  she  was  removed  to  hospital.    She  had 
no  direct  association  with  either  of  the  plague  households,  but  several  fellow- 
workers  had  been  at  one  or  other  "  wake." 

(d)  52  Dale  Street— 

At  this  address  a  man  (MT.),  employed  as  a  furnaceman,  sickened  on  25th 
August  with  symptoms  which  were  attributed  to  a  simple  pneumonia,  and 
died  on  the  29th.  He  was  buried  on  1st  September,  his  bed  being  gifted  to  a 
neighbour,  who  had  rendered  him  some  service.  The  recipient,  with  his  wife  and 
child,  slept  thereon,  and  on  8th  September  the  husband  sickened,  and  was  the 
first  case  of  plague  recognised  at  this  address.  On  the  following  day  he  was 
removed  to  hospital.  On  the  18th  a  relation  (Mrs.  G.),  living  on  the  floor  below, 
and  who  had  visited  and  assisted  in  nursing  him  before  his  removal  to  hospital, 
sickened,  as  did  also  one  of  her  children  (M.  G.).  The  man  who  died  here  of  the 
pneumonia  in  the  end  of  August  had  friends  resident  at  248  Mathieson  Street, 
where,  as  we  know,  an  illness,  ultimately  fatal,  had  begun  about  21st  August.  He 
was  said  to  have  visited  that  address  about  this  time,  but  this  could  not  be 
verified. 

In  none  of  these  cases  could  direct  association  with  the  "  wake  "  households 
be  discovered.  In  the  Florence  Street  and  Crookston  Street  cases  there  was 
association  with  persons  not  themselves  affected,  but  who  had  been  present  at  the 
Rose  Street  "  wake,"  and  the  time  incidence  of  their  attacks  suggests  some  manner 
of  indirect  transmission  of  the  infection,  which  a  subsequent  illustration  (7)  may  be 
regarded  as  supporting.  The  cases  at  57  South  Coburg  Street,  on  the  other  hand,  are 
not  known  to  have  been  directly  associated  with  any  "  wake  "  contact,  although  a 
jieighbour  and  frequent  visitor  of  the  Oxford  Lane  cases,  the  first  of  which 
sickened  on  12th  August,  was  also  a  visitor  at  the  South  Coburg  Street  tenement.  ^ 
The  first  attack  here  was  separated  from  the  others  by  an  interval  of  a  fortnight, 
which  may,  I  think,  suggest  that  she  found  her  infection  outside  her  home, 
although,  when  the  subsequent  cases  occurred,  no  record  of  her  movements  could 
be  obtained. 

(5 )  Govan  Cases. 

Meanwhile  a  case  of  the  disease  had  occurred  in  the  Burgh  of  Govan,  fatal 
towards  the  end  of  August,  but  having  no  traceable  association  with  the  Glasgow 
cases. 


1  On  an  earlier  statement,  that  she  visited  the  house  of  the  M,  family,  some  doubt  was  after- 
wards thro^vn. 


12 


(6)  Cases  occurring  in  Hospital. 

A  baby  born  in  hospital,  on  16th  September,  of  a  plague  mother, 
developed  cervical  buboes  8  days  after  birth,  and  died  of  recognisable  plague  on 
27  th  September.  Delivery  was  by  forceps,  and  the  buboes  developed  in  the 
lymphatics  arising  in  the  area  subjected  to  the  pressure  of  the  instruments. 

A  cleaner  in  the  plague  ward  in  hospital  sickened  of  the  disease  on 
13th  September,  nineteen  days  after  her  first  exposure,  and  on  the  9th  day  after 
she  had  received  an  immunising  dose  of  10  c.c.  Yersin's  serum  injected  sub- 
cutaneously.  Her  attack  was  of  the  mildest  character,  but  the  bacillus  was 
recovered  from  an  affected  gland. 

(7)  Transmission  of  Infection  by  a  Person  not  suffering  from  the  Disease,  hut  definitely 

exposed  to  Infection. 

Special  interest  attaches  to  the  following  case,  because  it  affords  an  illustra- 
tion of  the  transmission  of  infection  on  the  person  or  clothing  of  one  not  suffering 
from  the  disease,  although  definitely  exposed  to  infection.  The  importance  of  this 
incident  was  recognised  at  the  time,  and  made  the  subject  of  a  special  enquiry. 
(See  Report  in  Minutes  of  Corporation,  p.  1452.)  It  was  our  custom  on 
removing  the  inmates  from  an  infected  house  to  leave  everything  in  situ,  and 
fumigate  with  liquified  sulphur  dioxide  for  at  least  twelve  hours,  and  thereafter  to 
spray  surfaces,  &c.,  with  formalin  or  chlorine.  Clothing  which  was  to  be  removed 
for  further  treatment  by  steam  or  otherwise  was  thereafter  wrapped  in  sheets 
damped  also  with  formalin.  One  of  our  clothes  collectors  was  so  employed  on 
3rd,  6th,  and  10th  September.  Whether  he  carefully  followed  instructions  regarding 
the  removal  of  infected  articles  may  be  doubted,  as  on  the  13th  September  his  wife 
sickened  of  plague,  an  inguinal  bubo  developing.  Their  house  was  far  removed 
from  the  other  infected  houses,  and  there  was  no  other  discoverable  or  probable 
source  of  infection.  I  believe  the  husband  carried  it  on  his  clothing  or  person, 
although  it  may  be  open  to  question  whether  the  medium  was  infecting  dust  or 
fleas.  The  part  played  by  fleas  in  the  transmission  of  infection  is  referred  to  else- 
where. The  collector,  it  should  be  stated,  had  received  an  immunising  dose  of 
Yersin's  serum. 

This,  then,  represents  the  distribution  of  the  houses  invaded,  and  it  may 
make  the  development  of  the  outbreak  clearer  if  we  arrange  the  cases  in  groups 
according  to  the  order  of  sickening. 


TIME  DISTRIBUTION  OF  CASES. 

( 1)  3rd  August. 

Household  at  71  Rose  Street  is  invaded.  Two  out  of  four  inmates  sicken, 
and  "  wakes "  are  held  from  7th  to  10th.  On  12th  a  third  inmate  is  attacked, 
and  a  visitor  (Mrs.  T.),  residing  at  23  Oxford  Lane.  The  occupant  of  a  neighbour- 
ing house  (P.  F.)  sickens  on  the  13th,  and  an  occasional  visitor  to  an  adjoining 
house  (J.  C.)  on  the  17th. 

(£J  19th  August. 

Two  cases  begin  at  57  Thistle  Street,  and  attacks  follow  in  two  members  of 
the  same  family,  and  in  six  other  persons  who  attended  the  "  wake "  here  on 
21st  and  22nd  August.    The  last  of  these  sickened  on  31st  August. 

(3)  20th  and  23rd  August. 

(a)  Members  of  three  households,  in  Florence  Street,  Crookston  Street,  and 
57  South  Coburg  Street,  sicken.  These  have  had  no  direct  connection  with 
either  "  wake,"  but  one  (R.  M.)  was  associated  im  her  employment  with  several 
who  had  attended  that  at  Rose  Street.    A  second  (L.  M'L.)  was  nursed  occasionally 


13 

by  another  contact,  while  no  very  definite  information  can  be  obtained  regarding 
the  movements  of  a  third  (South  Coburg  Street  family)  before  her  fatal  illness 
developed.  It  is  regarded  as  plague  because  of  four  subsequent  cases  in  the 
family. 

(h)  K  contact  (Mrs.  G.)  with  Rose  Street  sickens  at  248  Mathieson  Street  on 
the  21st,  and  before  her  illness  is  discovered  two  others — her  daughter  and  a 
neighbour  (G.  H.) — have  been  attacked. 

(Jf.)  29th  August. 

(a)  A  man  (M'l.),  having  relations  living  in  Mathieson  Street,  sickens  at 
Dale  Street  on  25th  August,  and  dies  on  29th  of  a  pneumonia.  On  8th  September 
a  neighbour  (M'M.),  who  had  slept  in  his  bed,  sickens,  and  from  this  two 
secondary  cases  (Mrs.  G.,  who  nursed  M'M.,  and  her  daughter)  sicken  on  18th 
September. 

(b J  About  this  date  a  fatal  illness  occurred  in  Govan.    (Case  H.) 

It  was  acute  in  character,  fatal  on  the  second  or  third  day,  and  the  nature  of 
the  disease  verified  by  post-mortem  examination.  This  patient  had  no  traceable 
connection  with  the  Glasgow  cases,  and  may  thus  prevent  us  from  holding  as 
proved  the  direct  line  of  descent  from  the  Rose  Street  "  wakes  "  of  some,  at  least, 
of  our  own  cases,  especially  those  where  the  association  is  of  an  intangible 
character. 

(5)  loth  September. 
Clothes  collector's  wife  (Mrs.  B.)  sickens. 

In  the  following  Table  all  the  deaths  occurring  at  home  which  preceded 
recognisable  cases  are  included,  but  distinguished  by  letters  instead  of  consecutive 
numbering.  Case  H,  however,  was,  as  has  been  stated,  demonstrably  plague  on 
post-mortem  examination.  In  case  D,  also,  the  death,  although  occurring  in 
hospital,  was  not  at  the  time  regarded  as  plague.  (See  Dr.  Buchanan's 
observations.) 


TABLE  SHEWING  Cases  recognised  as  Plague,  and  including  certain 


No. 

Name. 

Age. 
Ytars. 

Sex. 

Addkess. 

OCODPATION. 

Date  of 

Recovery. 

M. 

F. 

Sickening. 

EemoTal  to  Hoepital. 

A 

Mrs.  B.,  - 

57 

1 

71  Rose  Street,    -      .       -  - 

Fisli  hawker,  - 

August  3, 

B 

Baby  B.,  - 

1 

71       do.,           ...  - 

„      3,  - 

I 

J.  B., 

60 

1 

71       do.,           -       -       -    .  - 

Dock  worker, 

„     12,  - 

August  27, 

2 

Mrs.  T.,  - 

40 

1 

23  Oxford  Lane,   -       -       -  - 

Domestic, 

„     12,  - 

„     27,  - 

1 

3 

P.  F., 

56 

1 

77  Rose  Street,    ...  - 

Shoemaker,  - 

„     13,  - 

,,  29, 

I 

4 

J.  C, 

24 

1 

1  Well  Street,  Calton, 

Slater's  labourer,  - 

„     17,  - 

„  30, 

I 

C 

C.  M.,  - 

9 

I 

57  Thistle  Street,  -       -  - 

At  school, 

„  19, 

5 

Mrs.  M.,  - 

40 

1 

57        do.,         -       .      .  . 

Domestic, 

„  20, 

August  25, 

I 

D 

Mrs.  G.,  - 

55 

1 

248  Mathieson  Street,  - 

Domestic, 

''I 

E 

M.  a, 

(Daughter  of 
Case  D). 

24 

1 

248  do., 

Charwoman,  - 

V 

6 

D.  T., 

7 

I 

23  Oxford  Lane,  - 

At  school. 

August  2] , 

Ancyn^t 

I 

P 

CM., 

14 

\ 

57  South  Coburg  Street, 

Cigarette  packer,  - 

22 

7 

P.  M. ,  - 

20 

1 

57  Thistle  Street,  -       -       -  - 

Slipper  maker, 

22 

August  25, 

g 

W.  M., 

3 

1 

57         do.,  .... 

„  23, 

„     25,  . 

1 

9 

T.  H., 

15 

I 

6  South  Coburg  Street, 

Nil, 

23, 

,,  29, 

1 

10 

R,  M.,  - 

28 

I 

23  Florence  Street, 

Hair  worker,  - 

23 

SlpTl'I'PTll  rlfP  1  f\ 

1 

11 

W.  W.,  - 

48 

21  Robert  Street,  Govan. 

Painter,  - 

About  4  weeks 
previous  to 
admission,  - 

20,  - 

... 

G 

G.  M'L,  - 

52 

1 

52  Dale  Street,  .... 

Labourer, 

August  25, 

... 

12 

E.  M'L.,  - 

] 

154  Crookston  Street, 

lOCIJLClllUd  Uj 

1 

13 

A.  M'K.,  - 

12 

1 

57  Thistle  Street,. 

At  school. 

„     28,  - 

August  29, 

I 

14 

A.  D,, 

18 

1 

Removed  from  Reception  House, 

Rivetmaker,  - 

„     28,  - 

„     29,  - 

I 

15 

J.  M., 

14 

1 

Do., 

Millworker,  - 

,,  28, 

„     29,  - 

1 

16 

P.  M'G.,  - 

18 

1 

Do., 

Labourer, 

,,  30, 

„     31,  - 

1 

17 

Ag.  R.,  - 

1 

Do., 

Nil, 

31, 

Septembei"-  3,  - 

I 

jj 

Go  Vein  Boy, 

I 

18 

G.  H.,  - 

46 

I 

248  Matliieson  Street,  - 

Boot-top  fitter, 

SsAri'f.pTnliPi'  1  ^5  . 

19 

C.  M'M.,  - 

27 

1 

52  Dale  Street,  .... 

Labourer, 

8,- 

9,- 

1 

20 

Mrs.  B.,  - 

29 

1 

81  Cubic  Street,  .... 

Domestic, 

13,  - 

14,- 

1 

21 

E.  R., 

21 

1 

Belvidere  Hospital,  - 

Ward  maid,  - 

13,  - 

14,- 

1 

22 

Mrs.  M.,  - 

20 

1 

57  South  Coburg  Street, 

Domestic, 

13,- 

15,  - 

23 

Mrs.  M.,  - 

41 

1 

57  do.. 

Domestic, 

14," 

16,- 

1 

24 

Mary  M.,  - 

14 

I 

57  do.. 

Nil, 

14,- 

15,- 

1 

25 

R.  M.,  - 

12 

1 

57  do.. 

At  school. 

14,  ■ 

16,- 

26 

Mrs.  G.,  - 

24 

1 

52  Dale  Street,  .... 

Domestic, 

18,  - 

19,  - 

1 

27 

M.  G., 

6 

1 

52       do.,  .... 

At  school. 

18,- 

19,  - 

28 

Baby  M.,  - 

8  days 

Belvidere  Hospital,  - 

24,- 

... 

X 

A.  A., 

18 

1 

3  Moss  Road,  South  Govan, 
(Removed  from  Western  Infirmary). 

Boilermaker,  ■ 

September  5,  - 

September  6,  - 

1 

Deaths  occureing  at  Home.   These  latter  are  distinguished  by  Letters. 


Deaths  in 

Nature  of  association  with  earlier 

Appro.ximate  duration  of 
Incubation. 

Nature  of  attack  and  site  of 
External  Bubo. 

Hospital. 

Home. 

cases.  ^ 

August  7, 
Do.  9, 

1st  Case  of  which  there  is  any 
\  record, 

Death  ascribed  to  Acute  Gastio 
Enteritis. 

Death     asciibed     to  Zymotic 
Enteritis. 

September  24,  - 

Husband  of  A, 

Relative,  and  helped  to  nurse  A , 

Lived  in  neighbouring  tenement 
to  A, 

Slept  in  house  next  door  to  A  on 
13th  August, 

Maximum,  9  days, 
Do., 

Maximum,  10  days, 
4  days, 

Right     inguinal.  Ultimately 
Septicseiuic. 

Left  inguinal,  complicated  with 
Abortion.  Severe. 

Left  inguinal.  Severe. 
Double  inguinal.  Mild. 

August  21, 

At  wakes  in  A's  house, 

8  days, 

Uncertain  whither  she  sickened 
simultaneously  with  her  child, 
Case  C, 

Death  ascribed  to  Pneumonia. 

Rlrfllt.  lIlffnTTlll  ^Ci\jcyfa 

AVi^iiu  iijyillllal.  ocvcre. 

September  4,  - 

Found  dead 
September   1,  - 

August  28, 

At  funeral  service  in  A's  house, 

Child  of  No.  2, 
None  known, 

10  days, 

A  possible  illustration  of  infection 
from    bubonic    attack    in  a 
parturient  woman,  but  associ- 

aLCLl  VVlLli  tjiic  VVaiit/O, 

Death  assumed  at  time  to  be  due 
to  Typhus  Fever. 

P.    M.    impossible    owing  to 
advanced  decomposition. 

Right  inguinal.  Mild. 
Death  ascribed  to  Pneumonia. 

August  27, 

Brother  of  Case  C, 
Do., 

In  C's  house  during  her  illness 
and  wake. 

Associated  with  visitors  at  C's 
house. 

4  days, 
2-3  days. 

Maximum,  4  days. 

Neck,  axilla,  groin,  and  abdomen. 
Septicasmic. 

Cervical.  Mild. 

Cervical,  right  inguinal  and  right 
femoral.  Severe. 

Double  inguinal.  Mild. 

October  6, 

August  29, 

August 

History  of  visits  to  248  Mathieson 
Street  at  time  of  D's  illness, 

Nursed  by  associate  of  visitors 
at  C's  wake. 

At  C's  wake, 

Do., 

Do., 

Do., 

Do., 

Maximum,  5  days, 

6-7  days. 
Do., 
Do., 

8-9  days, 

tz-io  uayb, 

Ultimately  Septica3mic. 

Death  ascribed  to  Pneumonia. 

Right  axilla.  Mild. 

Cervical.    Pestis  ambulans. 

Do.  do. 
Right  axillary.    Pestis  ambulans. 
Cervical.    Pestis  ambulans. 
Right  axillary.    Pcatis  ambulans. 

September  13,  - 

A  visitor  at  D's  house, 
Slept  in  G's  bed, 

Wife  of  employee  of  Sanitary 
Department, 

Maximum,  7  days, 

Right     inguinal.  Ultimately 
Septicemic. 

Left  axilla.    Cerebral.  Severe. 

Right  inguinal.  Mild. 

Posterior  cervical.    Pestis  ambu- 
lans.   Had  Serum  previously 

September  16,  - 

_  Household  in  which  Case  F. 
had  died. 

16  daj's' interval  elapsed  between 
the  first  of  these  cases  and 
Case  F, 

Left  inguinal,  with  general  septic 
infection.    Premature  labour. 

Right  inguinal.  Severe. 

Right  axilla.     Pustular  plague. 
Mild. 

September  28,  - 

Nursed  Case  19, 

9-10  days, 

Left  axilla.     Ultimately  Septi- 
cemic. 

Right   inguinal.      Mild.  Had 
Serum  previously. 

September  25,  - 

Daughter  of  26, 

Do., 

Right  inguinal.     Probably  ulti- 
mately SepticEemic. 

Do.       27,  - 

7-8  days, 

Cervical.  Septicajmic. 

See  pp.  16,  55,  and  70. 

16 


Arranged  in  weekly  periods,  the  impetus  which  the  infection  acquired  from 
the  "  wakes "  becomes  more  evident,,  and  I  have  placed  the  whole  series  in  this 
chronological  order  with  the  view  of  asking  whether  it  affords  any  information 
regarding  the  conditions  which  determine  the  infectivity  of  plague. 


Number  Sickening  in  Weekly  Periods,  with  Number  of  Fatal  Attacks 

Beginning  in  Each. 


August. 

Septemter. 

Week  Ending, 

4 

11 

18 

25 

1 

8 

15 

22 

i 

Total. 

Number  Sickening, 

-  2 

4 

11 

8 

2 

61 

36 

Number  of  Fatal  Attacks  be- 
ginning in  each  week,  - 

2a 

1 

6o 

2  c- 

I 

2 

2 

16 

1  These  figures  include  one  in  each  week  occurring  in  hospital. 
a  Cases  A  and  B. 

6  Includes  cases  C,  D,  E,  F,  and  G. 
c  Includes  case  H. 


TYPES  OF  THE  DISEASE. 

Professor  Zabolotny,  of  St.  Petersburg,  who  spent  a  considerable  time  with  us 
during  the  outbreak  in  a  study  of  the  serum-therapy  of  the  disease,  has  placed  on 
record  his  opinion  that  the  outbreak  was  mild  in  its  character  when  compared  with 
those  of  India,  China,  and  the  East  generally,  and  also  as  compared  with  the  more 
recent  European  outbreaks  at  Kolobowka  and  Oporto.  Particularly  he  lays  stress 
on  the  picture  of  protracted  illness  which  the  post-mortem  appearances  presented. 

In  J.B.  death  followed  only  after  forty-three  days'  illness  ;  in  G.H.  it 
occurred  on  the  tenth  day;  in  the  six  other  deaths  occurring  in  hospital  after 
intervals  of  from  two  to  seven  days  from  the  onset. 

Two  of  these  fatal  cases  (P.M.  and  Baby  M.)  were  septicsemic  in  t3rpe,  probably 
from  the  onset ;  in  the  others  the  septicasmia  was  secondary,  and  associated  with 
the  invasion  of  other  organisms. 

In  all  the  cases  external  buboes  were  present,  which  varied  in  situation  and 
size,  and  in  the  degree  of  involvement  of  surrounding  tissues ;  in  those  designated 
pestis  ambulans  the  affected  glands  were  small,  and  sometimes  so  deeply  seated 
that  puncture  was  attended  with  considerable  difficulty. 

In  one  case  only  were  the  affected  glands  not  tender  to  pressure  after  patient 
came  under  observation  (Case  D).  This  patient  was,  however,  comatose  on  admission. 
In  another  patient,  marked  X  on  table,  enlarged  glands  were  felt,  but  pressure 
elicited  no  evidence  of  tenderness.  This  case  is  not  included  in  the  list ;  but  a 
special  note  by  Dr.  Cairns  is  appended.^  Clinically  it  did  not  differ  from  a  severe 
pneumonia ;  but  doubt  existed  as  to  presence  of  b.  pestis  in  the  sputum,  and 
patient's  recovery  seemed  to  discredit  the  assumption  that  it  was  a  plague 
pneumonia.  The  probability  was  only  revived  when  the  agglutinative  reaction  was 
obtained,  and  serum  experiments  had  demonstrated  a  limited  protection  in  animals, 
from  inoculation  with  plague  virus. 

With  regard  to  the  degree  of  severity  of  attack,  the  following  classification  of 
the  hospital  cases  can  be  made : — Eight  were  fatal,  six  were  severe,  seven  were 
mild,  and  seven  were  so  slight  as  to  warrant  them  being  regarded  as  pestis 
ambulans.  In  these  latter  the  symptoms  belonged  to  the  same  category  as  in  the 
more  severe  cases ;  but  they  were  slightly  marked,  vanishing,  in  their  mildness. 


1  See  p.  55,  and  Table  III.,  p.  70. 


17 


almost  beyond  recognition.  Save  for  their  association,  ^ilague  as  an  explanation 
would  have  been  purely  conjectural,  except  by  the  recovery  of  the  bacillus  from  the 
affected  glands.  Most  of  these  developed  their  attacks  while  under  observation 
in  the  reception-house.  By  contrast,  all  the  deaths  occurring  at  home,  and 
which  are  now  to  be  regarded  as  plague,  followed  short-lived  illnesses.  Four 
had  a  definite  history  of  pneumonia.  Two  had  diarrhoeal  symptoms.  All  were 
probably  septicsemic  from  the  outset.  One,  when  found,  had  extensive  deep-seated 
glandular  enlargements  in  the  inguinal  regions,  presented  a  definite  petechial 
staining  of  the  skin,  and  was  regarded,  provisionally,  as  typhus  fever.  This  case 
was  admitted  to  hospital  before  death  occurred. 

The  symptomatology  as  presented  by  the  patients  in  hospital  is  discussed  by 
Dr  Brownlee  in  a  subsequent  section. 


THE  CONDITIONS  OF  SPREAD. 

In  describing  the  topographical  distribution  of  the  cases  we  have  seen  that, 
by  including  unrecognised  deaths  at  home,  a  more  or  less  tangible  thread  of 
association  can  be  established  between  all  of  them,  which  the  time  incidence  of  the 
attacks  strengthens. 

We  have  now  to  consider  the  manner  in  which  this  association  became 
established ;  and  on  this  the  after  history  of  the  wake  contacts  has  some  bearing. 

The  first  cases  which  occurred  (A  and  B)  had  marked  intestinal  symptoms ; 
and  the  fatal  termination  in  less  than  a  week  suggests  that  a  condition  of 
speticsemia  preceded  death.    In  these  cases  the  p.  bacillus  is  present  in  the  blood. 

Linen  soiled  with  the  discharges  from  the  patients  would  retain  the  infection ; 
and  it  is  a  fair  surmise  that  the  suctorial  parasites  of  mankind  are  equally  cajDable 
with  those  of  the  rat  of  abstracting  the  p.  bacillus  from  the  blood  of  a  human 
patient  where  a  plague  septicaemia  exists  Of  the  persons  pi'esent  at  the  wakes 
here,  four  afterwards  sickened.  Among  those  attending  the  Thistle  Street  wake, 
six  primary  attacks  resulted.  The  first  illness  in  the  Thistle  Street  household  was 
pneumonic  in  type ;  and  during  the  wakes  three  others  of  the  family  were  sick,  one 
of  them  of  plague  septicaemia.  Seven  families  altogether  were  resident  at  57 
Thistle  Street ;  but  attacks  occurred  only  among  those  who  had  been  present  at 
the  wakes,  although  the  importance  of  this  may  be  to  some  extent  discounted  by 
the  recognition  of  the  nature  of  the  disease  five  days  after  the  death  in  this 
household  occurred,  and  the  consequent  removal  of  all  the  known  contacts  to  the 
reception-house. 

Some  importance  also  attaches  to  the  new  centres  of  infection  created  by 
the  cases  who  obtained  their  infection  while  attending  the  wakes.  The  secondary 
case  which  occurred  at  Oxford  Lane  had  other  associations  with  the  wake  families, 
being  a  relative;  and  the  two  cases  marked  secondary  at  Thistle  Street  were  within 
the  time  limit  of  infection  from  their  sister,  who  died  of  pneumonia. 

But  the  patient  G.H.  (Case  18),  whose  sickness  was  definitely  secondary  to 
that  of  the  visitor  from  Mathieson  Street,  had  no  relation  with  Rose  Street, 
and  owes  his  attack  entirely  to  the  new  focus  established  in  the  Mathieson  Street 
household,  as,  indeed,  also  does  this  visitor's  daughter,  if  we  assume  that  her 
death  was  due  to  plague. 

Again,  of  the  primary  attacks  which  followed  from  the  first  wake,  two  out  of 
four  died — three  out  of  five  if  we  include  the  grandfather's  illness — and  one  who 
recovered  had  a  protracted  and  severe  illness ;  and  of  the  secondary  attacks 
developing  in  the  new  centres  of  infection  thus  formed,  three  deaths  again  occurred 
out  of  five  attacks.  In  this  connection  it  is  to  be  observed  that  severity  of  attack 
in  those  called  primary  infections  was  supplemented  by  prolonged  exposure  at 
home  on  the  part  of  those  who  sickened  secondary  thereto. 


18 


In  contrast  with  this  is  the  record  of  attacks  which  followed  the  second  wake. 
Here  only  one  was  severe  in  character,  and  there  were  no  secondary  attacks.  But 
it  is  to  be  remembered  that  by  this  time  we  had  become  alive  to  the  fact  that  we- 
were  dealing  with  plague,  and  an  active  search  for  the  discovery  and  segregation  of 
contacts  had  begun;  and  so  it  happened  that  four  of  these  primary  attacks 
developed  under  observation  in  the  reception-house.  A  fifth  was  under  observation 
at  home,  and  was  removed  to  hospital  on  the  day  following  sickening ;  while  the 
sixth,  the  only  severe  one,  had  sickened  on  August  23rd,  but  remained  at  home 
till  the  29th,  when  the  nature  of  his  illness  and  his  association  with  the  Thistle 
Street  cases  were  first  known. 

It  may  be  that  there  is  an  important  lesson  in  this,  could  we  read  it  aright. 
The  first  wake  was  held  in  a  dirtily-kept  one-apartment  house,  in  which  a  child 
was  dead  after  four  days'  illness,  and  a  woman  after  seven.  The  second  wake 
followed  an  illness  of  two  days'  duration ;  but  the  type  was  pneumonic,  and  three 
others  of  the  family  were  already  sick  or  sickening,  one  of  them  of  an  attack  which 
was  to  prove  fatal  in  a  few  days.  Save  in  the  existence  of  a  second  apartment,  this 
latter  house  was  like  the  other.  Either  would  have  offered  an  excellent  breeding 
ground  for  typhus  fever.  But  all  the  first  wake  contacts  sickened  in  their  own 
houses,  and  for  days  remained  there  undiscovered.  Thus  not  only  was  their 
infection  contracted,  but  the  wdiole  of  their  incubation  period  was  passed  in  the 
foetid  atmosphere  of  ill-kept  dwellings.  On  the  other  hand,  before  the  incubation 
period  had  passed  for  those  attacks  which  resulted  from  the  second  w^ake,  four  of 
them  had  been  removed  from  the  squalor  of  their  homes  to  the  cleanlier  conditions 
of  a  recejotion-house ;  and  these  attacks  were  so  mild  that,  save  for  the  circum- 
stances under  which  they  occurred,  they  would  never  have  come  under  medical 
observation  at  all.  Indeed,  the  analogy  of  smallpox,  modified  and  defaced,  as  it 
were,  by  almost  protective  vaccination,  was  forcibly  suggested  by  these  mild 
attacks  of  plague. 

I  am  disposed  to  connect  the  mildness  of  these  latter  attacks  with  the  healthier 
conditions  under  which  j)art  of  their  incubation  period  was  passed,  although  the 
numbers  are  too  small  to  encourage  any  attempt  to  overweight  their  importance. 
But  as  the  clinical  histories  of  the  patients  in  hospital  developed,  and  it  was 
possible  to  learn  something  from  j>ost-mortem  examinations  of  the  causes  which 
were  at  work  in  producing  the  fatal  issue,  it  began  to  be  recognised  that  plague 
not  only  powerfully  predisposes  to  septic  complications,  but  that  some  form  of 
double-infection  might,  indeed,  possibly  be  present  almost  from  the  beginning. 
Whatever  be  the  significance  of  this,  it  remains  as  an  observation  that  none  of 
the  attacks  which  developed  at  home  were  so  mild  as  those  occurring  among 
contacts  in  the  reception-house.  So  mild,  indeed,  were  these  latter  that  it  was 
difficult  to  regard  them  as  constituting  elements  of  danger  at  all  to  persons  in 
healthy  surroundings. 

In  the  whole  range  of  plague  literature,  no  feature  in  the  spread  of  the  disease 
is  more  uniformly  insisted  upon  than  its  association  with  local  conditions  of  grossly 
defective  hygiene.  Indeed,  it  is  from  this  circumstance  that  the  belief  in  an 
autochthonous  origin  of  plague  arose ;  and,  without  subscribing  to  the  theory,  we 
may  accept  the  facts  on  which  it  is  based  as  of  the  first  importance.  But  there  is 
something  more  to  be  considered.  By  what  means  do  locally  defective  conditions 
become  operative  in  the  spread  of  plague  ?  In  other  words,  is  the  potency  of 
plague  infection  determined  by  the  conditions  of  exposure  to  it  ? 

At  first  it  would  seem  as  if  this  implied  the  need  to  distinguish  between 
susceptibility  on  the  part  of  the  individual  and  the  conditions  under  which  exposure 
to  infection  takes  place;  but  many  things  point  to  this  latter  as  forming  the 
dominant  factor  in  determining  an  attack.  The  inmates  of  an  infected  dwelling, 
under  certain  conditions,  also  contract  the  disease ;  the  occasional  visitor  rarely,  if 
at  all.  Of  the  gang  of  dustmen  engaged  in  carrying  out  disinfection  in  Bombay, 
only  those  contracted  the  disease  who  lived  in  houses  of  bad  sanitary  condition. 


19 


Here  susceptibility  to  the  disease  would  seem  to  have  b^n  induced  by  conditions 
ejusdem  generis  with  those  which  favour  its  spread.  An  opposite,  and  quite  the 
most  interesting,  illustration  of  its  kind  which  I  have  found,  is  that  described  by  Dr. 
Cantlie.  ^  Eight  Chinese  students  of  the  College  of  Medicine  in  Hong  Kong  were 
engaged,  during  the  outbreak  there,  as  ward  attendants  and  clerks  in  the  plague 
wards  for  a  period  of  six  weeks,  and  they  shared  the  immunity  enjoyed  by 
Europeans  at  a  time  when  their  relations,  living  at  home,  were  being  attacked. 
They  lived,  however,  and  worked  under  conditions  which  afforded  little  opportunity 
for  the  plague  virus  becoming  concentrated,  and  to  this  their  protection  may  be 
attributed. 

With  this  illustration  we  may,  I  think,  dismiss  from  consideration  any 
argument  based  on  immunity  from  infection  enjoyed  under  corresponding 
conditions  of  exposure.  It  is  true  that  one  of  our  ward  cleaners  contracted  the 
disease  in  a  mild  form — cultivation  and  inoculation  experiments  with  the  dust  of 
the  ward  were  at  the  time,  unfortunately,  impossible — yet  the  statement,  I  believe, 
holds  good  that  plague,  even  more  than  typhus  fever,  may  be  handled  with 
comparative  immunity  under  the  conditions  obtainable  in  hospital  wards;  but  that 
it  may  be  conveyed  on  the  person  or  clothing  of  one  who  has  been  definitely 
exposed  to  infection,  but  is  not  ill  of  the  disease,  the  attack  on  the  wife  of  our 
clothes  collector  also  demonstrates.  And  here  there  was  neither  the  individual 
susceptibility  which  unhygienic  conditions  of  living  creates,  nor  the  simultaneous 
exposure  to  infection,  and  the  conditions  favourable  to  its  spread  at  a  point  where 
both  existed.  This  attack  also  was  mild  in  type.  There  was  no  superficial  abrasion 
of  the  cuticle  to  indicate  the  point  of  entrance  of  the  infection,  so  that  inoculation 
by  infectious  dust  may  presumably  be  excluded.  But  the  houses  of  the  majority 
of  the  cases  were  hotbeds  of  vermin,  and  the  clothes  collector,  like  all  those  who 
had  to  deal  with  the  infected  houses,  frequently  complained  of  the  annoyance  these 
insects  caused  him.  He  had  received  an  immunising  dose  of  10  c.c.  of  Yersin's 
serum  before  beginning  plague  work. 

It  may  be  that  some  of  the  cases  which  we  have  regarded  as  arising  from 
indirect  contact  owed  their  infection  to  quite  a  different  source — to  a  strain  of 
infection  kept  alive  through  a  series  of  cases  of  pestis  amhulans,  which  the  most 
diligent  search  failed  to  discover.  The  attack  of  the  clothes  collector's  wife, 
however,  introduces  a  new  aspect  into  our  conception  of  what  contact  implies.  It  is 
not  necessarily  contact  with  infectious  sick,  or  with  their  exhalations  or  discharges, 
but  with  infection  retained  in  the  secretions  of  an  insect,  which  has  obtained  it 
from  one  or  other  of  these. 

In  two  of  those  which  have  been  called  indirect  (P.F.  and  J.C.),  the  association 
was  not  with  persons  at  all,  but  with  locality ;  and  these  are  the  only  two  which 
suggest  radiation  of  the  infection  beyond  the  invaded  households  by  means  other 
than  personal  intercourse.  One,  we  have  seen,  slept  next  door  to  the  house  at  71 
Rose  Street  four  days  before  sickening,  and  the  other  lived  near  by  and  worked 
as  a  jobbing  shoemaker,  with  his  workshop  attached  to  his  house. 

The  death  from  pneumonia,  which  preceded  the  recognised  illness  at  Dale 
Street,  occurred  in  a  man  who  had  been  visiting  248  Mathieson  Street,  where  the 
attacks  were  septictemic ;  but  in  the  following  instance  there  is  a  suggestion  that 
the  plague  organism  passed  into  a  state  of  saprophytic  existence,  and  thereafter 
acquired  renewed  virulence,  or  maintained  it  in  some  way  not  presently  demon- 
strable. In  the  cases  to  which  I  have  already  referred  as  occurring  at  57  Coburg 
Street  the  attacks  develoj^ed,  one  on  the  13th  and  three  on  14th  September,  the 
earlier  and  one  of  the  latter  being  fatal,  one  being  a  parturient  woman,  and  the 
other  a  mixed  infection.  We  have  seen  that  a  death  occurred  here  on  28th 
August,  from  an  illness  which  began  on  the  22nd,  and  which  was  probably  plague 
pneumonia.    An  interval  of  sixteen"  days  thus  elapsed  before  the  next  sickening 


1  See  Transactions  Epidemiological  Society,  vol.  xvi.,  p.  24. 

^  An  incubation  period  of  fifteen  daj's  was  observed  during  the  Hong  Kong  outbreak. 


20 


occurred,  and  this  is  rapidly  followed  by  attacks  in  all  the  remaining  members. 
What  was  happening  in  the  interval  between  the  first  death  and  the  next 
sickening  ?  So  far  as  we  could  learn,  these  last  four  had  been  exposed  to  no  new 
source  of  infection  outside  their  dwelling.  The  house  was  on  the  third  floor  of  a 
four-storeyed  tenement,  housing  sixteen  families.  The  focus  of  infection  must  have 
been  strictly  localised,  as  no  other  household  in  the  tenement  was  affected.  Apart 
from  a  knowledge  otherwise  obtained,  one  might  infer  from  this  alone  that  the  rats 
here  were  not  infected.  It  may  be  that  the  virus  remained  in  the  bed  or  body 
clothing,  which  had  been  soiled  during  the  first  fatal  illness,  or  in  the  dirt  which 
prevailed  everywhere ;  but  laboratory  experiment  would  seem  to  show  that  after 
fourteen  days  artificially  infected  material  loses  its  virulence  if  kept  at  air 
temperature.    (See  earlier  reference  to  question  of  transmission  by  fleas). 

It  may  have  been  a  coincidence ;  but  one  of  these  cases  was  the  sole  example 
of  pustular  (cutaneous)  plague  which  occurred,  the  first  vesicles  appearing  under 
the  right  shoulder  blade.    (Case  24.) 

The  small  number  of  plague  contacts  who  develop  the  disease  while  under 
observation  has  frequently  attracted  notice.  In  the  segregation  camps  of  India,  in 
Sydney,  and  elsewhere,  the  experience  has  been  the  same ;  and  the  inference 
usually  drawn  is  that  the  direct  source  of  infection  is  in  the  surroundings  rather 
than  in  the  patient.  This,  I  think,  is  partly  true,  although  we  have  seen  that  the 
Bombay  dustmen  required  more  than  exposure  to  the  infected  house  to  produce 
the  disease  in  them.  Those  who  were  attacked  had  been  rendered  susceptible  by 
residence  in  unhealthy  surroundings. 

But  there  is  a  sense  in  which  the  type  of  attack  in  the  individual  may  be  said 
to  determine  the  infectivity  of  his  neighbourhood.  Variation  in  type,  indeed, 
appears  to  be  more  important  than  variation  in  severity  of  attack.  The 
pneumonic  patient  may  eject  the  bacilli  into  the  air,  and  the  septicsemic  afford 
facilities  for  the  transmission  of  the  disease  by  insects.  Wherever  this  form  was 
present  during  treatment  at  home,  secondary  cases  followed.  This  was  seen  in  the 
deaths  which,  at  the  time  of  their  occurrence,  were  unrecognised,  and  from  71 
Rose  Street,  57  Thistle  Street,  57  South  Coburg  Street,  and  52  Dale  Street, 
dissemination  of  the  disease  also  took  place. 

But  in  Well  Street,  77  Rose  Street,  Florence  Street,  Crookston  Street,  6 
South  Coburg  Street,  Cubic  Street,  and  in  the  Govan  patient  (H.),  no  secondary 
infection  followed,  although  intervals  varying  from  one  to  nineteen  days  elapsed 
between  sickening  and  removal  of  the  patients  to  hospital.  These,  save  the  Govan 
case,  might  be  called  bubonic  in  type.  Forty-five  persons  were  known  to  have 
visited  the  six  Glasgow  patients  just  noted.  All  of  them  escaped  infection,  and  the 
opinion  expressed  by  Montanus,  and  quoted  by  Boghurst,  that  a  slight  plague 
infects  not  "  unlesse  a  body  bee  extremely  fitted  to  receive  it,"  has  quite  a  modern 
illustration. 


21 


ADMINISTRATIVE  MEASURES. 


The  recognition  of  the  disease  created  a  new  problem  for  the  sanitary 
administration,  and  made  it  necessary  to  recast  several  of  the  executive  methods. 

The  outbreak  at  Oporto  in  the  previous  year  had  led  to  increased  activity  on 
the  part  of  port  sanitary  authorities,  with  the  view  of  arresting  the  introduction  of 
the  disease  through  shipping.  The  geographical  position  of  Glasgow,  however,  places 
it  at  a  disadvantage  in  this  respect.  Within  its  own  municipal  area  it  is  unable  to 
protect  itself  against  sea-borne  infection ;  and  the  occurrence  of  indigenous  plague 
in  the  only  considerable  port  of  the  country  which  has  no  constituted  port  authority 
is  suggestive.  Such  limited  examination  of  ships  and  crews  from  infected  ports 
as,  in  the  circumstances,  was  possible,  had  been  conducted  during  the  year ;  and 
a  record  was  kept  of  foreign-coming  passengers  who  had  entered  the  country  in 
infected  ships  through  other  ports  in  the  kingdom.  In  no  case  was  any  illness 
discovered  suggestive  of  plague ;  and  none  of  the  passengers  who  had  come  off 
infected  ships  resided  within  the  infected  area. 

The  occurrence  of  the  cases  without  any  traceable  connection  with  the  soux'ce 
of  infection  made  domiciliary  visits,  with  a  view  to  the  discovery  of  others,  a  first 
necessity ;  whilst  the  facilities  which  bad  hygienic  conditions  were  known  to  afford 
for  the  spread  of  the  disease  made  the  introduction  of  a  higher  standard  of 
domestic  cleanliness  in  the  neighbourhood  of  the  infected  houses  second  only  in 
importance  to  this.  Fortunately,  the  means  by  which  the  latter  could  be  enforced, 
and  the  former  object  accomplished,  lay  to  hand  in  Section  254  of  the  local  Police 
Act  of  1866,  which  owes  its  origin  to  the  typhus  fever  prevalences  in  the  middle 
of  the  century.  1  It  supplied  a  lever  by  which  practically  anything  which  could  be 
regarded  as  affording  a  suitable  nidus  for  the  saprophytic  existence  of  the  plague 
organism  might  be  speedily  exorcised  ;  and  I  am  inclined  to  regard  it  as  one  of  the 
most  valuable  statutory  powers  we  possess.  It  brought  the  limewasher  and 
scavenger  into  active  co-operation  with  the  housewife,  and  established  for  dirty 
areas  "  spring  cleaning  "  on  a  fairly  extensive  scale. 

In  view  of  the  possibility  of  a  rat  infection,  the  condition  of  disused  basement- 
flats,  cellars,  and  the  like  became  important ;  and  this  clause  was  extensively 
applied  in  procuring  the  cleansing  of  such  places. 

An  emergency  meeting  of  the  Magistrates  Committee  and  of  the  Committee 
on  Health  was  held  on  31st  August,  and  the  following  extracts  will  indicate  the 
line  of  action  recommended  and  approved  thereat : — 

The  Medical  Officer  of  Health  reported  that  in  the  district  of  the  city  bounded  by  Cumberland 
Street  on  the  south.  South  Wellington  Street  on  the  east,  Adelphi  Street  and  Carlton  Place  on  the 
north,  and  Bridge  Street  and  Eglinton  Street  on  the  west,  plague  or  similar  epidemic  disease  exists  in 
such  district,  and  that  it  would  be  desirable  to  use  special  sanitary  measures  in  order  to  prevent  the 
spread  of  such  disease  ;  and  the  Magistrates  Committee,  having  considered  said  report,  approved 
thereof,  and  remitted  to  the  Medical  Officer  of  Health  to  forthwith  enforce  the  provisions  of  Section 
254  of  the  Glasgow  Police  Act,  1866,  within  the  said  district. 


1  "  On  a  report  by  the  Medical  Officer  that  in  any  district,  street,  or  court  it  would  be  desirable 
to  use  special  sanitary  measures  in  order  to  mitigate  the  severity,  or  prevent  the  spread  of  epidemic, 
endemic,  contagious,  or  other  disease,  or  that  any  such  disease  prevails,  or  exists,  and  threatens  to 
prevail,  in  such  part  of  the  city,  the  Magistrates  Committee  may  approve  tliereof  ;  and  on  such  an 
approval  it  shall  be  lawful  for  the  Medical  OlBcer  to  give  notice,  in  manner  hereinafter  provided,  to 
the  proprietor  or  occupier  of  any  dwellingdiouse  situated  in  the  p.irt  of  the  city  in  which  the  Medical 
Officer  has  reported  that  it  appears  to  him  desirable  to  use  special  sanitary  measures,  requiring  such 
proprietor  to  cleanse  and  limewash  the  outside  thereof,  and  the  common  stair  and  lobbies  and 
staircases,  and  requiring  such  occupier  to  cleanse  and  whitewash  the  interior  thereof,  and  to  purify, 
ventilate,  and  disinfect  the  said  dwelling-hous^,  or  any  apartment  or  apartments,  or  bedding  or 
clothes  therein." — Glasgow  Police  Act,  1866,  Sec.  254. 


The  Medical  Officer  of  Health  explained  to  the  Joint-Committee  that  he  proposed  that  the 
following  line  of  action  be  immediately  adopted  in  dealing  with  the  existing  state  of  matters,  viz.  : — 

(1)  ( a)  That  in  each  land  fi-om  which  a  case  is  removed  the  lobbies,  staircases,  common  passages, 

and  each  house  be  disinfected  and  cleansed  by  the  Sanitary  Department — the 
Cleansing  Department  making  special  arrangements  for  emptying  and  cleansing 
ashpits  and  hosing  out  courts  ; 
(h)  That  tenements  from  which  "contacts"  are  removed  be  dealt  with  similarly  to  the 
foregoing  ; 

(2)  That  the  district  above  defined  be  constituted  a  special  cleansing  area,  the  provisions  to 

include  a  thrice-weekly  emptying  of  ashpits,  limewashing  thereof,  hosing  of  courts, 
special  removal  of  rubbish,  &c. ; 

(3)  That  medical  inspection  of  the  district  be  organised  and  carried  out  by  the  medical  staff  of 

the  Sanitary  Department,  with  the  addition  of  two  duly  qualified  and  suitably  experi- 
enced medical  practitioners,  and  that  inoculation  with  anti-plague  serum  be  offered,  free 
of  charge,  where  deemed  advisable  ; 

(4)  That  a  special  sanitary  inspection  for  dirty  stairs  and  houses,  and  for  overcrowding  of  houses, 

be  instituted  ; 

(5)  That  ratcatchers  be  employed  for  service,  where  deemed  necessary,  within  the  said  district ; 

and 

(6)  That  a  handbill  be  posted  within  the  district  directing  the  attention  of  the  pirblic  to  the  fact 

that  immediate  medical  attention  may  be  had  from  the  Sanitary  Department  on  com- 
municating therewith  through  the  nearest  police  office  or  station. 
The  Joint  Special  Committee  approved  of  the  foregoing  operations  proposed  by  the  Medical 
Officer  of  Health,  and  directed  the  Sanitary  Inspector,  the  Superintendent  of  Cleansing,  and  the 
Chief  Constable,  and  all  other  officials  interested,  to  act  in  constant  co-operation  with  the  Medical 
Officer  of  Health  in  fully  and  efiectually  carrying  out  the  said  proposals,  and  safeguarding  the  public 
health. 

The  Joint-Committee  agreed  to  recommend  that  it  be  remitted  to  the  Medical  Officer  of  Health, 
the  City  Engineer,  the  Sanitary  Inspector,  and  the  Clerk,  to  enquire  as  to  obtaining  further  suitable 
and  adequate  reception-house  aceoaimodation,  and  to  report  on  the  result  of  their  enquiries  to  the 
Lord  Provost  and  Councillor  James  Dick,  with  power  to  the  latter  members  of  Committee  to  authorise 
the  acquisition  of  such  additional  reception-house  accommodation. 

The  Joint-Committee  resolved  to  propose,  at  a  special  meeting  of  the  Corporation  as  the  Local 
Authority  under  the  Infections  Disease  (Notification)  Act,  1889,  which  special  meeting  the  Lord 
Provost  had  directed  to  be  convened  for  Tuesday,  4th  proximo,  at  1.30  o'clock,  the  following 
resolution,  viz.  : — ''The  Corporation,  as  Local  Authority  for  the  City  and  Royal  Burgh  of  Glasgow 
under  the  Infectious  Disease  (Notification)  Act,  1889,  declare,  in  terms  of  Section  7,  Sub-section  6,  of 
said  Act,  that  emergency  arises  in  consequence  of  the  existence  within  the  city  of  certain  cases  of 
plague,  and  therefore  order  that  said  Act  shall,  in  the  district  of  the  said  Local  Authority,  apply  to 
'Plague,'  and  that  for  the  period  from  the  expiration  of  one  week  from  the  date  of  the  advertisement 
to  be  made  in  terms  of  said  Act  till  the  31st  day  of  December,  1900." 

The  scheme  of  action  thus  outlined  was  carried  into  effect  in  the  manner 
described  in  the  following  extract  from  the  Report  of  the  Medical  Officer  to  the 
Health  Committee  on  10th  September  following : — 

The  scheme  of  action  approved  of  at  the  special  meeting  of  the  Magistrates  Committee  and  the 
Committee  on  Health,  held  on  3)st  August,  is  being  carried  out  in  the  following  detail  in  the  defined 
area,  and,  as  then  authorised.  Dr.  Frederick  Dittmar  and  Dr.  Alfred  Webster  have  been  added  to 
the  staff : — 

( 1 )  Within  this  district  special  cleansing  operations  are  being  conducted  in  the  following  detail : — 

(a)  Ashpits  are  being 

(1)  emptied  three  times  a  week,  and 

(2)  washed  once  weekly  with  "  chloride  of  lime  whitewash"  (1  lb.  "chloride 

of  lime  "  added  to  12  gallons  of  freshly-slaked  lime  solution  of  the  con- 
sistency of  milk).i 

(6)  Back  courts  in  dirty  condition  are  hosed  every  night  with  "chloride  of  lime" 
solution,  1  in  100  (1  lb.  "chloride  of  lime"  to  10  gallons  water).  [For  this 
solution  "  chloros  "  was  afterwards  substituted,  owing  to  a  mechanical  difficulty 
in  the  distribution  of  the  "  chloride  of  lime  "  mixture.] 

(2)  A  special  inspection  of  the  district  is  taking  place  for  the  detection  of  dirty  houses,  closes,  &c., 

and  for  overcrowding  of  houses. 

(3)  Infected  tenements,  and,  if  necessary,  those  where  "contacts"  reside,  are  being  dealt  with 

as  in  (8). 


1  To  secure  uniformity  in  the  strengtli  oi  tlie  caustic  lime  solution,  the  proportions  specified  in  tlie  Venice  Convention 
"Were  subsequently  substituted,  viz.,  10  lbs,  of  dry  lime  to  3i  gallons  of  water. 


23 


(i)  Medical  inspection  of  the  district  is  being  carried  out ;  the  ocrapants  of  the  infected  tene- 
ments, and  all  "contacts/'  are  oflfered  inoculation  with  Yersin's  serum,  and  others  in 
neighbourhood  with  Haflkine's  prophylactic.  Suspected  cases  are  being  seen  with  the 
medical  attendants. 

(5)  Plague  has  been  added  to  the  Infectious  Disease  (Notification)  Act,  1889. 

(6)  Handbills  are  being  distributed  offering  the  services  of  the  medical  staff  at  any  time,  on 

application  to  the  nearest  Police  Office. 

(7)  Efforts  are  being  made,  through  co-operation  with  the  surgeons  of  the  shipping  companies,  to 

arrange  for  medical  inspection  of  Lascars  and  other  crews  of  ships  from  infected  countries. 

(8)  The  detailed  arrangements  for  the  removal  of  cases  and  disinfection  of  infected  tenements 

are  under  the  personal  supervision  of  one  of  the  medical  staff,  and  may  be  detailed  as 
follows  : — 

(a)  l!emoval  of  patient  to  hospital. 

(b)  Removal  of  "contacts"  to  reception  house. 

(c)  Fumigation  of  infected  house  by  liquified  sulphur  dioxide  from  12  to  2-1  hours, 

the  disinfectant  being  used  in  proportion  to  the  cubic  space  dealt  with. 
id)  After  the  fumigation  the  house  is  entered;  all  articles  of  clothing,  &c.,  to  be 
removed,  are  first  of  all  thoroughly  wetted  with  2  per  cent,  solution  of  formalin 
(1  gallon  40  per  cent,  solution  formaldehyde  to  50  gallons  waterj,  then  wrapped 
up  in  sheets  soaked  in  the  same  fluid  and  removed  to  the  Sanitary  Wash-house. 
There  all  articles  which  cannot  be  boiled  or  steamed,  or  treated  with  formalde- 
hyde, are  burned. 

(e)  The  walls,  ceiling,  flooring,  wood  work,  &c.,  of  the  infected  house  are  also  sprayed 
with  the  formalin  solution  (1  gallon  to  50  gallons  water). 

(/)  All  houses  in  the  infected  tenement  are  cleansed  by  the  Department ;  the  lobbies, 
stairs,  and  closes  being  dealt  with  by  formaldehyde  or  "chloride  of  lime" 
solution. 

ig)  Courts  of  such  tenements  are  watered  with  "chloride  of  lime"  solution. 
(h)  Ash-pits  have  contents  watered  with  same  and  then  removed  and  burned. 
(9)  Clinical  demonstration  of  cases  in  hospital  is  given  daily. 

(10)  A  pamphlet  descriptive  of  the  varieties  of  the  disease  has  been  prepared  for  circulation 

among  practitioners. 

(11)  The  co-operation  of  hospital  and  other  dispensaries  for  the  detection  of  doubtful  glandular 

affections  has  been  invited. 

(12)  Mats. — Ratcatchers  have  been  employed,  and  the  existence  of  disease  in  rats  is  being 

enquired  into. 

A  circular  has  been  issued  to  hospitals  and  dispensaries  intimating  the  presence  of  plague,  and 
directing  the  attention  of  the  medical  staff  to  the  need  for  carefully  scrutinising  all  suspected  persons ; 
and  one  also  to  shipowners  impressing  upon  them  the  desirability  of  having  the  crews  of  ships  arriving 
from  suspected  ports  abroad  kept  under  medical  observation  while  in  port. 

********  -X-* 

Detail  of  Disixfection. 

In  some  of  the  houses  which  have  had  to  be  dealt  with  there  were  some  few  fabrics  which  could 
only  be  disinfected  by  some  germicide  in  gaseous  form  ;  and  for  this  purpose  formic  aldehyde  is  being 
added  to  the  details  formerly  stated.  An  epidemic  inspector  has  also  been  set  apart  to  supervise, 
under  the  directions  of  the  medical  staff  and  of  the  district  inspector,  the  carrying  out  of  the  details 
of  cleansing  which  in  those  cases  is  a  necessary  complement  of  the  process  of  disinfection. 


QUESTION  OF  GLANDULAR  AFFECTIONS. 

We  knew  from  our  death  registers  that  acute  king  diseases  were  not  unusually 
prevalent — that,  indeed,  no  class  of  disease  existed  causing  death  in  such  numbers 
as  to  suggest  the  prevalence  of  unrecognised  plague ;  and  the  services  of  the 
various  hospital  and  dispensary  staffs  were  enlisted  with  the  view  of  discovering 
whether  ill-defined  forms  of  glandular  affection,  Avith  fever,  were  present  in  unusual 
number  among  the  persons  attending  for  treatment.  The  result  of  this  also  was 
negative. 


24 


CIRCULAR  LETTER  TO  DISPENSARY  PHYSICIANS. 

Sanitary  Department, 
23  Montrose  Street, 
Glasgow,  8th  September,  1900. 

Dear  Sib, 

PLAGUE. 

Will  you  allow  me  to  bring  under  your  consideration  the  advantage  which  will 
result  at  the  present  juncture  to  the  sanitary  administration  of  having  the  active  co-opei'ation  of  all 
hospital  and  other  dispensaries  in  the  following  direction. 

Those  who  are  familiar  with  the  recent  literature  of  plague  will  have  prominently  before  them 
the  almost  uniform  record  of  glandular  enlargements  of  an  indefinite  character  which  have  preceded 
outbreaks  of  the  recognised  disease.  Sir  Richard  Thorne,  for  example,  in  his  last  report  remarks  : — 
"Fever  with  glandular  swellings  prevailed  in  Bombay  before  it  was  recognised  that  plague  had 
reached  that  city;  and  it  is  impossible  to  read  the  medical  history  of  this  disease  in  almost  every 
part  of  the  world  without  being  impressed  with  the  frequency  with  which  recognised  plague  has  been 
preceded  by  ailments  of  such  slight  severity,  involving  some  bubonic  enlargement  of  glands,  and  some 
rise  in  body  temperature,  as  to  mask  the  real  nature  of  the  malady." 

With  this  experience  elsewhere,  and  the  presence  of  recognised  cases  of  plague  in  hospital,  there 
will,  I  think,  be  a  distinct  public  advantage  if  the  attending  physicians  of  dispensaries  will  carefully 
scrutinise  all  glandular  affections  of  doubtful  origin,  with  the  possibility  of  their  association  with 
plague  in  view. 

I  need  hardly  add  that  every  assistance  which  can  be  rendered  by  the  medical  staff  here  will  be 
at  your  disposal. 

Yours  truly, 

A.  K.  CHALMERS. 

In  carrying  out  the  house-to-house  visitation,  the  medical  inspectors  made  a 
wide  circle  of  inspection  of  persons  residing  round  infected  and  contact  tenements ; 
and  practitioners  generally  rendered  valuable  service  by  bringing  doubtful  illnesses 
under  scrutiny.  In  addition,  the  inspectors  for  the  discovery  of  dirty  houses 
reported  any  illness  not  medically  attended,  with  a  view  to  these  being  visited  by 
the  medical  staff. 

Many  of  the  cases  which  were  thus  brought  under  scrutiny  could  be  definitely 
excluded  on  an  examination  of  the  symptoms  and  history  of  illness ;  but  several 
were  removed  to  hospital  for  observation,  and  the  most  interesting  are  detailed  in 
the  third  interim  report.^  Our  experience  was  that  septic  conditions  of  glands 
were  those  which  most  closely  simulated  plague.  In  all  recent^  cases  the  absence 
of  the  bacillus  pestis  from  fluid  obtained  by  puncturing  the  affected  gland  set  the 
question  at  rest.  The  serum-reaction  with  a  fresh  culture  of  the  bacillus  has  in 
this  respect  also  a  definite  value  after  the  first  week  of  illness.^ 

Reference  is  elsewhere  made  to  late  information  which  was  obtained  of  the 
arrival  in  Glasgow,  early  in  the  summer,  of  a  vessel  trading  with  plague-infected 
ports  in  India,  among  whose  crew  there  appeared,  during  the  passage  from  London 
to  Glasgow,  a  glandular  affection  accompanied  by  fever ;  and  the  following  circular 
resulted  in  a  voluntary  arrangement  by  which  the  crews  of  all  such  vessels  were 
kept  under  medical  supervision  while  in  port : — 

CIRCULAR  LETTER  TO  SHIPPING  AGENTS. 

Sanitary  Department, 
23  Montrose  Street, 
Glasgow,  8th  September,  1900. 

Dear  Sir, 

PLAGUE. 

Circumstances  which  have  come  to  my  knowledge  render  it  extremely  desirable,  in 
the  interests  both  of  the  shipping  of  the  port  and  of  the  community  generally,  that  the  crews  of  ships 
from  plague-infected  ports  should,  under  present  circumstances,  be  placed  under  a  system  of  medical 
surveillance  while  in  port  here.  This,  I  believe,  may  best  be  accomplished  at  present  by  the  custom 
being  generally  adopted  which  obtains  in  certain  firms  of  arranging  with  individual  surgeons  who 
might  act  in  co-operation  with  this  department. 

I  shall  be  glad  to  hear  from  you  on  this  suggestion  at  your  earliest  convenience. 

Yours  truly, 

A.  K.  CHALMERS. 


1  Page  36. 

=  See  Dr.  M'Olure,  p.  57. 
^  See  Dr.  Cairns,  p.  67. 


PUBLIC  NOTICE. 


WAKES. 

The  Lord  Provost  and  Magistrates  have  had  under  consideration  tlie  prominent  part  which  has 
been  pLayed  by  the  Iiolding  of  wakes  over  the  dead  in  the  recent  visit  of  plague,  and  woidd  strongly 
urge  upon  the  public  the  necessity  and  the  duty  of  discontinuing  the  custom.  These  ceremonies, 
while  meant  to  be  acts  of  friendly  remembrance,  are  fraught  with  danger  to  the  health  of  all  who 
take  part  in  them,  and  thus  to  the  well-being  of  the  community  at  large. 

They  would  also  remind  the  public  that  it  is  illegal  to  hold  a  wake  over  the  body  of  a  person 
who  has  died  of  any  infectious  disease. 

By  Order. 

J.  LINDSAY,  Int.  Clerh, 
Corporation  Police  Department. 

City  Chambers,  12th  September,  1900. 


Sanitary  Chambers, 

23  Montrose  Street, 

Glasgow,  22nd  October,  1900. 

CIRCULAR  LETTER  TO  THE  KEEPERS  OF  SEAMEN'S  AND  EMIGRANTS' 
LODGING  OR  BOARDING  HOUSES. 

Sir, 

The  recent  occurrence  of  several  cases  of  plague  in  the  city  possesses  a  special  interest 
to  all  connected  with  shipping,  and  particularly  to  those  who  are  in  daily  association  with  emigrants 
or  seamen. 

Plague  can  be  introduced  by  persons  who,  although  suffering  from  the  disease,  can  undertake 
journeys  of  a  considerable  distance,  and  it  may  be  so  mild  that,  unless  the  symptoms  are  specially 
examined  by  a  doctor,  its  presence  may  readily  be  overlooked. 

As  long  as  plague  is  present  in  foreign  countries,  there  will  exist  a  pressing  necessity  for  care- 
fully examining  every  illness  in  per-sons  coming  therefrom,  and  the  possibility  of  its  occurrence 
among  persons  of  this  class  should  be  constantly  before  you. 

The  Public  Health  (Scotland)  Act,  1897,  imposes  on  common  lodging-house  keepers  the  duty 
of  informing  the  Sanitary  Authority  of  the  occurrence  of  infectious  disease  in  any  of  the  inmates  of 
these  houses.  It  is  also  provided  in  Bye-law  25  of  those  applicable  to  common  lodging-houses  that 
"If  any  person  or  persons  in  a  common  lodging-house  shall  become  ill,  the  lodging-house  keeper 
shall  at  once  ascertain  from  a  legally  qualified  medical  practitioner  whether  the  said  person  or  persons 
are  affected  with  fever  or  other  infectious  disease.''  Should  the  illness  be  of  this  character,  the 
lodging-house  keeper  is  bound  to  inform  the  Officers  of  the  Sanitary  Department  thereof.  Neglect 
either  to  obtain  medical  advice  in  these  circumstances,  or  to  inform  the  Sanitary  Department  of  the 
existence  of  infectious  disease,  renders  the  keeper  liable  in  a  penalty  of  five  pounds  (£5). 

Plague  is  now  added  to  the  list  of  infectious  diseases  under  the  Notification  Act,  which  also 
places  on  the  householder  the  duty  of  intimating  the  occurrence  of  any  infectious  disease  to  the 
^Medical  Officer  of  Health. 

Communication  with  the  Sanitary  Chambers  and  with  the  Medical  Officer  of  Health  may  at  any 
time  be  obtained  through  the  nearest  Police  Station. 

Yours  truly, 

A.  K.  CHALMERS,  M.D  , 

Meuical  Officer  of  Health. 


DISINFECTION  AND  EVACUATION  OF  INFECTED  HOUSES. 

On  the  recognition  of  each  case  the  unattacked  members  of  the  family  were 
removed  to  a  reception-house,  together  with  every  visitor  who  could  be  traced. 
Disinfection  of  the  infected  house  was  thereafter  carried  out  in  the  manner  already 
detailed ;  and  every  house  in  the  tenement  was  similarly  treated — papered  walls, 
surfaces  of  furniture,  &c.,  being  sprayed  with  formalin,  while  to  unpapered  walls, 
lobbies,  staircases,  &c.,  the  chlorinated  lime  solution  was  applied.  The  houses  of 
contacts  were  dealt  Avith  in  a  similar  manner ;  and  the  application  extended  to  the 
whole  tenement  in  this  case  also,  where  the  character  of  the  tenants  rendered  this 
•desirable.  On  the  completion  of  these  processes  of  chemical  disinfection,  the 
evacuated  houses  were  unoccupied  until  the  dismissal  of  the  inmates  from  the 
reception-house,  and  the  windows  left  open,  in  order  that  complete  aeration  of 
the  interior  might  be  accomplished. 


26 


Disinfection  in  practice,  however,  has  many  meanings  and  many  requirements. 
A  room  with  well-plastered  walls,  solid,  and  with  no  crevices  into  which  dust  might 
drift  and  insects  find  a  hiding-place,  with  the  flooring  good,  and  the  seams  between 
the  boards  not  gaping,  is  easily  disposed  of;  but  where  the  plaster  is  old,  blistered, 
and  broken,  the  laths  uncovered  in  places,  and  the  flooring  irregular  and  with 
gaping  seams,  the  possibility  that  disinfectants  will  reach  the  crevices  in  which 
dust  gathers  and  infection  may  lodge  is  a  remote  one,  and  it  must  be  remembered  that 
the  possibility  of  a  saprophytic  existence  of  the  bacillus  of  pest  has  been  entertained. 
Standing  in  the  middle  of  such  a  room  from  which  a  plague  pneumonia  had  been 
removed,  the  question  which  pressed  for  answer  was,  can  any  form  of  liquid  or 
gaseous  disinfection  accomplish  its  object,  the  method  of  applying  it,  and  the  place, 
being  taken  into  account  ?  To  get  at  the  crevices  you  must  remove  the  plaster, 
and  broken  flooring  can  only  be  dealt  with  by  getting  it  up  and  turning  out  the 
deafening,  and  the  process  of  disinfection  is  finished  only  when  complete  renoVation 
of  the  interior  is  accomplished.  The  problem  in  this  form  was  placed  before  the 
owners  of  all  the  invaded  houses ;  and,  without  exception,  they  willingly  acquiesced 
in  completing  the  work  which  chemical  disinfection  may  be  said  only  to  have 
begun. 


SUPERVISION  OF  CONTACTS. 

The  segregation  in  the  reception-houses  of  persons  who  had  been  in  association 
with  the  infected  houses  was  accomplished  without  having  recourse  to  the  statutory 
powers  existing  both  in  the  Public  Health  (Scotland)  Act,  1897,  and  in  the  local 
Police  Act,  for  removing  them  under  warrant.  During  the  period  in  which  they  were 
under  observation  there,  but  especially  when  they  were  dismissed  and  had  returned 
to  their  homes,  some  apprehension  existed,  and  was  occasionally  expressed,  that  the 
freedom  of  intercourse  with  the  general  public  permitted  to  them  was  attended 
with  risk  of  spreading  the  disease.  This  in  the  circumstances  was  natural ;  but 
these  persons  were  not  sick,  and  consequently  were  not  infectious.  In  cholera  an 
attack  may  be  ushered  in  with  uncontrollable  vomiting  and  diarrhoea,  which  would 
establish  a  focus  of  infection  at  the  point  of  seizure.  There  was  nothing  in  plague, 
as  we  saw  it,  similar  to  this,  so  that,  after  washing  their  clothing  and  the  use  of  a 
bath,  our  reception-house  inmates  were  allowed  to  attend  their  work  in  the  usual 
way ;  but  living  in  a  reception-house  instead  of  in  their  homes,  and  under  daily 
medical  examination.  There  was  no  evidence  that  the  freedom  allowed  them  was 
prejudicial,  although,  with  a  different  type  of  disease  predominating,  the  practice 
might  require  to  be  revised. 

Rats  were  numerous  in  many  of  the  infected  tenements,  and  in  those  in  which 
the  type  of  the  disease  was  pneumonic  or  intestinal,  opportunities  of  infection,  in  all 
likelihood,  occurred.  On  the  recognition  of  the  cases,  inquiry  failed  to  discover  any 
evidence  that  rat-mortality  prevailed  to  an  unusual  extent ;  and  when  a  definite 
system  of  examination  was  begun,  nearly  three  hundred,  killed  by  trapping,  or  found 
dead  in  ashpits  or  elsewhere,  chiefly  within  the  area  of  infection,  were  bacteriologi- 
cally  examined  without  evidence  of  pest  being  discovered  in  any  of  them.  Various 
efforts  were  made  to  accomplish  their  destruction  by  some  means  more  expeditious 
than  trapping.  Rats  can  be  driven  from  their  haunts  most  readily  by  the  fumes  of 
sulphur  dioxide ;  and  when  escape  is  impossible,  as  in  the  hold  of  a  ship,  they 
readily  succumb  to  its  action.  In  a  simple  system  of  sewerage  it  is  possible,  as 
was  done  at  Belvidere  Hospital,  to  rid  the  drains  absolutely  by  such  means  j  with 
a  more  complex  system,  the  difficulties  might  well  tax  the  resources  of  ingenuity, 
as  when  means  of  escape  exist,  the  rats  are  only  dispersed.  Indeed,  one  of  the 
chief  difficulties  in  dealing  with  rats  arises  from  the  intelligent  apprehension 
displayed  by  them  of  efforts  to  accomplish  their  destruction.  A  few  may  be  killed 
by  poison  or  by  trapping,  but  the  majority  migrate.  Sick  rats,  indeed,  are  deserted 
by  their  fellows.    If  they  are  already  plague-infected,  their  dispersal  would  seem 


27 


doubtful  policy ;  and  their  destruction  can  at  best  only  be  partial.  With  the  view 
of  procuring  their  extinction  in  one  of  the  hospitals,  Danzy's  serum  was  experi- 
mentally fed  to  them,  in  the  hope  that  the  results  might  lead  to  its  more  extensive 
use ;  but  it  quite  disappointed  expectation.  None  of  the  rats  to  whom  it  was  fed 
died;  and  of  two  which  were  inoculated  with  it,  only  one  succumbed  to  the 
infection. 


VENICE  CONVENTION. 

The  present  Convention  is  in  force  for  five  years  from  the  date  of  its 
ratification,  which,  for  the  majority  of  the  signatory  governments,  was  1898.  It  is 
renewable  quinquennially  "  on  the  same  condit  ions ; "  and  this  suggests  con- 
sideration of  some  of  its  requirements,  because  non-compliance  with  them  by  the 
government  of  an  infected  country  cancels  the  obligation  of  the  other  governments 
to  restrict  the  precautions  against  infection,  stipulated  in  the  Convention,  to  the 
shipping  coming  from  that  part  of  a  country  which  is  declared  to  be  infected.  In 
the  following  letter  these  difficulties  are  explained  at  length,  and  it  was  made 
the  basis  of  a  representation  to  the  Local  Government  Board : — 

[Copy.] 

Sanitary  Chambers, 
Glasgow,  ITtli  October  1900. 

John  Lindsay,  Esq., 

Interim  Clerk  of  Police. 

Dear  Sir, 

PLAGUE. 


CIRCULAR  LETTER  FROM  LOCAL  GOVERNMENT  BOARD,  4th  OCTOBER,  1900, 
Enclosing  Copies  of  Chapters  2,  3,  and  4  of  the  Venice  Convention. 

Will  you  allow  me  to  return  to  the  subject  of  our  conversation  some  days  ago  concerning  the 
phrasing  of  Section  page  6,  of  the  above  quotations  from  the  Venice  Convention.  The  terms  used 
suggest  the  conditions  of  a  contract,  the  object  of  the  contract  being  to  prevent  the  introduction  of 
plague,  while  securing  a  minimum  interruption  to  commerce.  Certain  minimum  restrictions,  it  is 
agreed,  shall  be  imposed  by  tiie  governments  of  non  infected  countries  in  the  event  of  plague 
appearing  in  any  of  the  other  countries  represented  at  the  Convention.  But  the  obligation  to 
restrict  interference  to  this  minimum  standard  is  dependent  on  the  government  of  the  infected 
country  taking  measures  to  prevent  tire  exportation  from  its  infected  area  of  articles  declared 
susceptible.  These  articles  are  described  in  Section  4,  Chapter  II. ,  of  the  Convention.  The  inference 
seems  to  be  that,  if  this  condition  is  not  complied  with,  the  non-infected  countries  may  impose 
restrictions  on  persons  and  goods  coming  from  any  port  of  the  infeetid  country,  and  not  only  on 
those  from  the  area  which  may  be  infected.  We  were  agreed  that  the  "government  '  referred  to  in 
Section  3  is,  in  present  circumstances,  the  Imperial  Government,  but  if  you  refer  to  page  2  of  the 
Local  Government  Board  circular,  accompanying  these  extracts,  you  will  find  it  stated  that  on  Local 
Authorities  rests  the  burden  of  giving  practical  effect  to  the  conditions  under  discussion.  Section  III. 
(Chapter  II.  of  the  Convention)  appears  to  base  tlie  restricted  enforcements  of  these  precautions  by 
non-infected  governments  on  the  stipulation  that  exportation  of  susceptible  articles  from  the  infected 
area  shall  be  prevented,  but  it  is  also  stated  that  the  information  which  the  governments  of  infected 
countries  must  communicate  to  the  others  shall  include  a  description  of  tlie  measures  taken  regarding 
the  departure  of  ships  as  well. 

Dealing  first  with  the  question  of  susceptible  articles,  I  beg  to  enclose  you  copy  of  a  letter  which 
I  forwarded  to  the  Local  Government  Board  on  28th  September,  in  which  the  possible  application 
for  this  purpose  of  Sections  16  (G)  and  50  (1)  (o)  of  tlie  Public  Health  Act  is  discussed,  and  its  prac- 
ticability set  aside. 

If  my  reading  of  these  sections  is  correct,  we  are  unable  to  give  effect  to  one  condition  of  the 
Venice  Convention — that  is,  we  have  no  power  to  prevent  the  exportation  of  articles  which  cannot  be 
defined  as  a  "nuisance"  or  certified  as  "infected." 


28 


The  question  regarding  the  examination  of  persons  leaving  port  in  an  infected  area  may  be 
considered  on  a  somewhat  different  footing.  It  is  referred  to  in  Chapter  II.,  Section  1,  as  one  of  the 
items  of  information  to  be  communicated  to  other  governments,  but  the  "  measures  to  betaken  in 
Europe"  do  not,  as  I  read  them,  include  medical  examination  of  passengers  and  crews  and  disinfec- 
tion of  non-infected  out-going  ships  by  a  sanitary  authority  situated  as  we  are  at  the  present  moment. 
This  opinion  I  have  already  stated  to  you  in  my  letter  of  10th  inst. ,  but  the  question  is  of  consider- 
able importance  to  commerce,  and  the  absence  of  any  system  of  inspecting  the  passengers  and  crews 
of  all  out-going  ships  may  be  interpreted  abroad  as  a  violation  by  us  of  the  terms  of  the  Convention. 
As  you  are  aware,  the  Health  Committee  lately  approved  of  a  voluntary  agreement  by  which  I  under- 
took to  examine  the  crews  of  certain  ships,  but  this  is  only  possible  through  the  courtesy  of  the 
shipowners  and  the  acquiescence  of  the  crew,  and  its  scope  is  very  limited.  If  either  must  be 
done  to  fulfil  the  terms  of  the  Convention,  do  statutory  powers  exist  enabling  us  to  do  so  ?  Section 
45  of  the  Public  Health  Act  is  quite  specific  where  there  is  reason  to  believe  that  infectious  disease 
exists,  but  can  reasonable  grounds  for  entry  and  inspection  be  alleged  in  the  case  of  every  ship 
leaving  an  infected  port  ? 

If  my  observations  on  the  legal  aspects  of  these  questions  commend  themselves  to  you,  may  I 
suggest  that  the  matter  be  brought  undsr  the  consideration  of  the  Health  Committee,  with  the  view 
of  their  presenting  to  the  Local  Government  Board  a  statement  of  the  difficulties  which  exist  in 
Local  Authorities  giving  effect  to  two  conditions  of  the  Venice  Convention. 

Yours  truly, 

(Signed)      A.  K.  CHALMERS. 


BACTERIOLOGICAL  AND  PATHOLOGICAL  REPORT  ON  THE  CASES 
OF  PLAGUE  IN  BELVIDERE  HOSPITAL  IN  AUGUST,  1900,  BY 
ROBERT  MUIR,  M.D.,  PROFESSOR  OF  PATHOLOGY,  UNIVERSITY 
OF  GLASGOW. 

In  accordance  with  the  request  of  the  Pubhc  Health  Committee,  conveyed  to 
me  by  Dr.  Chahners  on  Monday,  August  27th,  I  have  investigated  the  bacteriology 
and  pathology  of  the  cases  of  suspected  plague  in  Belvidere  Hospital,  and  beg  to 
report  as  follows.  (A  Preliminary  Report  was  communicated  to  Dr.  Chalmers  on 
Thursday,  August  30th.) 

In  making  these  investigations  my  endeavours  were  directed,  in  the  first  place, 
to  the  separation  and  cultivation  of  the  special  bacillus  from  the  cases,  and,  in  the 
second  place,  to  the  determination,  by  scientific  methods,  of  its  identity  with  the 
bacillus  of  bubonic  plague.  In  addition,  I  performed  the  2^ost-mortem  examination 
in  the  case  of  P.  M.  on  Tuesday,  August  28th,  and  have  to  state  in  brief  the  results 
of  that  examination. 

In  summarising  the  results  it  will  be  convenient  to  place  them  under  the 
following  three  heads : — 

(I.)  The  characters  of  the  bacillus  isolated  in  pure  culture — is  it  the  bacillus 
of  bubonic  plague  ? 

(II.)  The  presence  or  absence  of  tbat  bacillus  in  the  various  cases  examined. 
(III.)  The  pathological  changes  in  the  body  of  P.  M. 

I.  The  bacillus,  cultivated,  in  the  first  instance,  from  P.  M.  during  life,  was 
examined  as  regards  the  following  characters : — 

(a)  Structural  Characters  and  Staining  Reactions. 

Under  this  heading  may  be  mentioned  size  and  shape,  grouping  in  various 
cultures  and  in  the  tissues  of  the  body,  absence  of  motility,  presence  of  polar 
staining,  decolorisation  by  Gram's  method,  production  of  involution  forms  under 
various  conditions,  absence  of  spores,  &c. 

(b)  Cultural  Characters. 

These  were  studied  in  various  media,  including  agar,  Haffkine's  salt-agar,  blood 
serum,  peptone-gelatine,  and  bouillon. 


29 


(c)  Pathogenic  Effects  in  various  Lower  Animals. 

As  regards  the  various  points  enumerated  under  the  above  headings,  the 
organism  was  found  to  correspond  in  every  particular  with  the  bacillus  of  bubonic 
plague;  and  I  may  especially  state  that  the  pathogenic  results  of  the  plague 
bacillus  were  reproduced  in  animals  by  inoculation  with  the  pure  cultures  obtained 
from  the  human  subject. 

The  result  of  these  investigations  is  to  demonstrate  that  the  organism  in 
question  is  without  doubt  the  bacillus  of  bubonic  plague. 

II.  I  have  examined  nine  cases  bacteriologically.  For  this  purpose  I  have 
punctured  the  affected  glands,  and  have  examined  the  fluid  obtained  both 
microscopically  and  by  means  of  cultures. 

The  following  are  the  results  : — 

In  the  cases  of  P.  M.  (No.  7),  P.  F.  (No.  3),  T.  H.  (No.  9),  and  J.  B.  (No.  1), 
the  bacillus  of  plague  was  found  on  microscopic  examination,  and  also  cultivated 
in  a  pure  condition.  In  the  case  of  (Mrs.  M.,  No.  5),  a  few  degenerated  plague 
bacilli  were  found  on  microscopic  examination,  but  I  did  not  obtain  cultures. 
Two  days  previous  to  my  examination,  however.  Dr.  M'Clure  obtained  pure 
cultures  of  the  plague  bacillus;  and  the  negative  results  obtained  by  me  were 
in  all  probability  due  to  the  fact  that  the  disease  was  in  process  of  cure,  and 
that  the  bacilli  were  dying  out.  The  five  patients  mentioned  have  thus  been 
demonstrated  to  have  suffered  from  bubonic  plague ;  and  it  is  of  interest  to  note 
that  in  none  of  them  was  any  other  organism  than  the  plague  bacillus  obtained 
from  the  glands. 

The  following  were  examined  with  negative  results,  viz. : — D.  T.  (No.  6), 
Mrs.  T.  (No.  2),  A.  D.  (No.  14),  and  J.  C.  (No.  4).  [This  does  not  prove, 
however,  that  these  patients  had  not  plague.  In  fact,  the  three  last-n'xentioned 
were  recovering  at  the  time  of  examination;  and,  if  they  had  plague,  the  bacilli 
would  be  few,  if  not  entirely  gone.] 

III.  On  Tuesday,  August  28th,  I  made  a  j>ost-mortem  examination  on  the 
body  of  P.  M.  I  found  an  almost  general  bubonic  affection  of  the  lymphatic 
glands,  those  especially  involved  being  in  the  right  armpit  and  in  the  neck.  The 
glands  were  greatly  swollen  and  inflamed,  partly  hjemorrhagic,  and  partly  softened, 
while  the  surrounding  tissues  were  the  seat  of  inflammatory  oedema  and 
haemorrhages.  On  microscopic  examination,  these  glands  were  found  to  contain 
enormous  numbers  of  plague  bacilli.  The  spleen  was  swollen  to  twice  its  normal 
size.  [It  is  unnecessary  to  give  greater  details — a  full  report  has  been  entered  in 
the  Pathological  Records  in  Belvidere  Hospital.]  The  sum  total  of  the  changes 
found  are  met  with  in  no  other  disease  than  bubonic  plague. 

As  a  summary  of  the  facts  above  stated,  I  have  to  report  that,  up  to  the 
present  date,  five  patients  have  been  proved  by  bacteriological  methods  to  have 
suffered  from  bubonic  plague,  and  that  one  of  those  (P.  M.)  died  from  that  disease. 

In  conclusion,  I  have  much  pleasure  in  acknowledging  the  valuable  collabora- 
tion of  Dr.  M'Clure  in  the  bacteriological  work,  and  the  kind  assistance  which  I 
have  had  from  Dr.  Brownlee  and  other  members  of  the  staff  of  Belvidere  Hospital. 

ROBERT  MUIR. 

Pathological  Laboratory, 
University  of  Glasgow, 
September  2nd,  1900. 


30 


THE  SIGNIFICANCE  OF  PHLYCTENULES. 

Extract  from  Report  by  Frank  Tidswell,  M.B.,  D.P.H.(Camb. ),  appended  to  Report  ox 
THE  Outbreak  op  Plague  at  Sydney  ix  1900,  by  the  Chief  Medical  Officer  of  the 
Government  of  New  South  Wales. 

As  the  outcome  of  close  inquiry  into  the  circumstances  attendant  upon  the  well-known  liability 
to  plague  infection  as  a  consequence  of  handling  rats  dead  of  the  disease,  Simond  states  that  a  plague 
rat  is  dangerous  or  not  in  accordance  with  the  time  that  has  elapsed  since  it  died.  If  handled  soon 
after  death,  plague  may  follow ;  but  if  not  touched  for  some  hours  it  may  then  be  handled  without 
risk.  It  was,  says  Simond,  just  as  if  the  infection  completely  evaporated  within  a  few  hours  after 
death.  He  also  states  that  perfectly  healthy  rats  harbour  very  few  fleas,  and  are  very  expert  in 
removing  them  ;  but  as  they  become  sick  they  neglect  their  toilet,  and  fleas  become  more  and  more 
abundant  upon  them,  so  that  they  sometimes  swarm  upon  moribund  rats.  After  death,  on  cessation 
of  the  circulation,  and  as  the  body  becomes  cold,  the  fleas  leave  it  and  seek  another  host. 

By  associating  the  "evaporation''  of  the  infection  with  the  departure  of  the  fleas,  Simond 
inferred  that  these  parasites  were  implicated  in  the  transport  of  the  infection.  This  inference  was 
further  supported  by  clinical  observations  of  two  kinds,  viz. — the  site  of  the  bubo  and  the  existence 
of  a  phlyctenule.  Simond  noticed  that  persons  becoming  plague-stricken  after  handling  a  dead  rat 
did  not  necessarily  develop  their  bubo  in  the  axilla.  As  often  as  not  in  such  cases  the  bubo  was 
femoral.  Hence  the  infection  was  not  due  to  direct  contact  with  the  rat,  but  to  some  associated 
circumstance,  such  as  invasion  by  fleas  from  the  rat.  It  is  obvious  that  such  fleas  might  inflict  a  bite 
and  inoculate  the  bacilli,  not  on  the  hand  or  the  arm,  but  on  the  leg  or  trunk,  and  thus  produce  a 
bubo  elsewhere  than  in  the  axilla. 

^  *  *  *  *  *  * 

Examinations  were  made  of  fleas  from  healthy  human  beings,  from  a  plague  patient,  from  mice, 
from  rats,  and  from  cats.  The  microscopical  examinations  all  proved  negative  except  in  the  case  of 
fleas  obtained  from  a  rat  actually  sick  with  plague.  This  rat  was  taken  in  a  house  from  which  a  case 
of  plague  had  been  removed  five  days  previously,  and  in  the  vicinity  of  wliich  many  persons  were 
attacked.  The  animal  was  killed  with  chloroform,  and  about  a  dozen  apparently  stupefied  fleas  were 
obtained  from  its  body.  The  fleas  were  crushed  up  in  a  few  drops  of  sterilised  distilled  water,  and 
as  preparations  from  the  emulsion  so  obtained  showed  micro-organisms  resembling  plague  bacilli,  the 
remainder  of  it  was  inoculated  into  a  guinea-pig.  The  animal  became  sick,  and  died  on  the  seventh 
day.  The  post-mortem  appearances  were  those  of  plague,  and  micro-organisms  resembling  bacilli 
pestis  were  found  in  the  bubo,  in  the  blood  of  the  heart,  in  the  spleen,  and  in  the  liver, 

In  the  experiments  performed  with  living  fleas  the  conditions  described  by  Simond  were  slightly 
modified.  A  rat,  selected  because  of  its  having  many  fleas  upon  it,  was  inoculated  with  plague 
bacilli  from  a  culture  and  placed  in  a  small  wire  cage.  A  second  healthy  rat  was  placed  in  a  similar 
wire  cage.  The  two  cages  containing  the  rats  were  both  placed  in  the  same  (sheet-iron)  larger  cage, 
the  interval  between  them  being  about  two  inches.  The  inoculated  rat  died  in  three  days,  and  its 
dead  body  was  allowed  to  remain  in  the  cage  for  twenty-four  hours.  It  was  then  removed,  and  on 
examination  was  found  to  be  generally  infected  with  plague.  The  other  rat  remained  perfectly  well 
for  a  period  of  four  weeks.  The  experiment  was  i-epeated  under  exactly  the  same  conditions,  except 
that  numerous  fleas,  obtained  by  the  chance  discovery  of  a  mouse's  nest,  were  thrown  into  the  cage, 
and  upon  the  inoculated  rat.  This  animal  also  died  in  three  days,  its  body  left  twenty-four  hours  in 
the  cage,  and  when  examined  found  to  be  generally  infected  with  plague.  A  third  rat  was  placed  in 
the  uncleaned  cage.    Neither  the  first  nor  the  third  rat  became  infected. 

It  will  be  seen  that  the  observations  we  had  the  opportunity  of  making  in  this  laboratory  gave 
support  to  Simond's  assertions  as  regards  the  presence  of  plague  bacilli  in  phlyctenules  and  in  fleas 
from  plague  rats,  and,  whilst  the  results  in  the  experiments  with  living  fleas  were  negative,  it  has  to 
be  noted,  that  such  tests  are  obviously  liable  to  miscarry  owing  to  the  several  uncontrollable  fa-ctors 
involved  in  their  performance. 


PROTECTIVE  INOCULATION. 

On  1st  September  a  supply  of  Yersin's  serum  was  obtained,  and  protective 
inoculation  of  the  hospital,  reception-house,  and  sanitary  staffs  engaged  in  plague 
work  was  begun.  It  was  also  offered  to  the  friends  of  patients  who  had  been  in 
contact  with  them,  and  to  the  tenants  and  others  in  the  neighbourhood  of  infected 
houses.  Without  exception  these  latter  declined  the  offer,  and  only  five  contacts, 
other  than  those  engaged  in  dealing  with  the  cases,  accepted  it.  Of  these  five 
two  developed  the  disease  in  an  exceedingly  mild  form  (Cases  21  and  26);  but  it 
should  be  observed  that  the  attacks  developing  in  the  four  reception-house 
inmates  (who  had  no  seriim)  were  also  of  this  character.  In  all,  seventy  persons 
received  injections,  the  quantity  used  varying  in  amount  from  10  to  20  c.c.  In 
addition  to  this,  nine  of  the  patients  in  hospital  were  treated  with  the  serum  for 


31 


curative  purposes,  the  dose  varying  from  40  to  100  c.c.s.  Buring  the  observations 
on  these  latter  cases  it  became  apparent  that  the  intravenous  use  of  the  serum  was 
attended  with  better  results  where  the  symptoms  could  be  regarded  as  due  to 
plague  only,  uncomplicated  with  any  other  form  of  coccal  infection,  than  when 
injected  subcutaneously,  but  the  more  careful  technique  required  in  this  form  of 
injection  is  almost  unattainable  in  persons  not  in  hospital.  The  details  of  this  work 
were  carried  out  by  Dr.  Alfred  Webster,  and  the  Table  on  the  following  page  prepared 
by  him  is  of  interest  because  of  the  careful  record  it  presents  of  the  constitutional  and 
local  symptoms  which  followed  the  injections.  It  was  decided  to  use  the  serum  in 
preference  to  the  other  prophylactic  available,  because  of  the  impression  that  this 
latter,  in  persons  already  exposed  to  infection  and  probably  incubating  the  disease, 
might  be  attended  with  risk,  but  there  is  reason  now  for  thinking  that  this 
impression  is  erroneous.  One  of  the  medical  staff  was  inoculated  with  Haffkine's 
prophylactic. 


ABSTRACT  OF  METEOROLOGICAL  OBSERVATIONS  TAKEN  AT 
GLASGOW  OBSERVATORY,  1900. 


Months. 

Tempekatdee. 

Rain. 

Highest 
Temperature 
in  Sliade. 

Lowest 
Temperature 
in  Shade. 

Mean 
Temperatm'e 
for  Month, 

Departure 
from  average 
of 

32  Years. 

No.  of  Days 
it  fell. 

Amount 
Collected. 

Departure, 
32  Years. 

January, 

51-r 

30-2° 

39-6° 

+  1-2 

25 

4-56 

+  0-88 

February, 

50-0° 

14-8° 

34-0° 

-5-2 

14 

2-86 

-0-20 

March, 

52-7° 

26-2° 

37-8° 

-  2-4 

8 

0-43 

-  2-06 

April,  ... 

66-9° 

32-7° 

45-6° 

+  0-9 

18 

2-04 

+  0-06 

May,  

69-5° 

35-7° 

49-9' 

+  0-5 

17 

2-16 

-0-32 

June,  ... 

74-0° 

43-9° 

56-3" 

+  1-1 

17 

4-34 

+  1-59 

July,  

73-9° 

46-3° 

58-7' 

+  1-2 

23 

3-54 

+  0-41 

August, 

77.70 

45-8' 

56-0° 

-0-8 

17 

4-91 

+  1-08 

September, 

68-2'' 

39-2° 

53-5° 

+  0-6  1 

17 

3-38 

-0-30 

October, 

60-r 

31-3° 

46-3° 

-0-4 

20 

5-44 

+  1-78 

November, 

57-8° 

27-0° 

43-2* 

+  1-2 

21 

5-86 

+  2-11 

December, 

55-0° 

34-3° 

44-2° 

1 

+  5-7 

29 

7-34 

+  3-38 

32 

Phrophylatic  Use  of  Yersin's  Serum — Dosage  and  Results. 


1900. 


Name  nnd  Status. 


Quantity. 


Length  of 
Exposure. 


Constitutional  untl  Local  Sj  mptoms. 


September  1, 
1, 


3, 
3, 
3, 
2, 


October 


3, 
3, 
3, 

3, 
3, 
3, 
3, 
5, 
5, 
5, 
5, 
5, 
7, 
7, 
7, 
7, 
7, 
7, 
7, 
7, 
7, 
9, 
9, 
10, 
10, 
10, 
10, 
10, 
10, 
4, 
10, 
10, 
10, 
10, 
10, 
10, 
14, 
14, 
14, 

14, 
14, 
15, 
15, 
15, 
16, 
16, 
20, 
20, 

21, 
25, 
25, 
25, 


29, 
1, 
1, 
1, 
1, 
1, 
1, 
1, 


Dr., 
Dr., 
Dr., 

Dr.,        -       -  - 
Dr., 

Dr.,        -       -  - 
Dr.. 

Nurse, 

Nurse, 
Nurse, 
Nurse, 
Nurse, 

Ward  Maid,  - 

Van  Driver, 

Nurse, 

Nurse, 

Nurse, 

Nurse, 

Nurse, 

Dr., 

Dr., 

Bact.  Laby.  Assistant, 
Inspector, 

Dr.," 

Dr.,        -       -  - 
Dr., 

"W'ashing-house  Staff, 


Mrs.,  27  Warwick  Street, 
Dr.,  .... 
Van  Driver, 
Collector. 

Washing-house  Staff, 


J.  T.,  . 

Mrs.,  52  Dale  Street, 
J., 

Mrs.,  ,, 
M'L, 

Mrs.,  ,, 

Mrs.,  23  Florence  Street, 

Keception-liouse  Staff, 


Ward  Maid,  - 

>^  ' 
Nurse,     -       .       .  . 
Nurse,     -       -       .  . 
Dr.,        .       .       .  . 
W.,  57  S.  Coburg  Street, 

C,  

J.,  52  Dale  Street,  - 

G.,  

Dr.,  .  .  -  . 

Dr.,  .  .  .  . 

Dr.,  .  .  .  . 

Dr.,  .  .  .  . 


Dr.,        -  • 
D.,  Belvidere, 
D., 

M'M., 
M., 
M'C, 
K., 
S., 


10  c.c. 


20  c.c. 
10  CO. 


20  c.c. 

15  CO.* 
15  c.c* 
20  cc 


10  cc 
20  cc. 


Dayv. 
9 
9 
9 


No  contact. 
7 

No  contact. 


No  contact. 


2 
15 
14 
14 
14 
14 
14 
14 
15 

2 

•  > 

2 
2 
2 
21 

No  contact. 


22 

September  14. 
No  contact. 
8 


13 
30 
30 

No  contact. 


Erythema  and  urticaria,  7th  day. 
Urtiicaria,  7th;  acute  arthritis,  11th. 
Urticaria,  10th  to  12th  ;  marked  fascial  and  articu- 
lar pain,  2nd  to  3rd  week  ;  general  malaise. 
Erj'thema,  oth  day  ;  urticaria,  7th  day. 
Erythema  urticaria.  8th  day. 
Erytliema  urticaria,  7tli  day. 
Urticaria,  8th  day. 

Erythema  urticaria,  1st  week  ;  joint  pains,  2nd 
week. 

Erythema,  3rd  day  ;  urticaria,  4th  day. 


Erythema,  5th  day  ;  urticaria,  Sth  day  ;  joint 

pains,  Sth  day. 
Sickened  on  Sept.-  13  with  symptoms  of  plague, 

enlargement  of  cervical  glands. 
Erythema  urticaria,  1st  week. 
,,  ,,         5th  day. 

,,  ,,         10th  day  ;  joint  pains,  11th 

to  15th  day. 
Erythema  virticaria,  joint  pains,  4th  day. 
Erythema. 

Erythema  urticaria,  1st  week. 
Erythema,  9th  ;  urticaria  and  joint  pains,  10th. 
Erythema  urticaria,  Sth  day. 
,,  ,,       7th  day. 


Erythema  urticaria,  8  to  10  days. 
,,  ,,        7  to  9  days. 


Malaise  at  end  of  1st  week. 


Enlargement  of  axillary  gland. 


Erythema  and  urticaria,  Sth  day. 
Developed  plague  on  September  18. 
Erythema  on  6th  day. 


Erythema,  2nd  day  ;  joint  pains,  10th  day. 

Erythema  and  urticaria,  7th  day  ;  acute  joint 
pains,  14th  day. 


Acute  general  joint  pains,  10th  day. 
Local  erythema  and  urticaria. 
Urticaria,  Sth  day  ;  joint  pains,  4th  day. 


Erythema    and  cedema   of   the    arm  around 
puncture  on  2nd  day. 


Erythema  and  urticaria  on  11th  day  ;  cedema  of 
legs  and  ankle,  12th  day  ;  acute  joint  pains  in 
hip,  knee,  and  ankles,  with  general  malaise. 


Contacts  in  the  ward,  Belvidere. 


*  Second  injection. 


APPENDIX. 


INTERIM   REPORT  BY  MEDICAL  OFFICER  OF  HEALTH,  SUBMITTED 
TO  HEALTH  COMMITTEE  ON  10th  SEPTEMBER,  1900. 

At  last  fortnightly  meeting  of  the  Committee  I  reported  that  a  careful  study  of  the  symptoms 
presented  by  three  patients  then  in  hospital  gave  rise  to  the  conviction  that  they  were  suffering  from 
plague.  This  conviction  was  ultimately  established  beyond  doubt,  and  the  following  narrative 
describes  the  circumstances  of  the  outbreak  so  far  as  at  present  known. 

*  *  *  *  *  *  *  *  *  # 

(See  page  22. ) 

Immediately  the  suspicion  of  plague  was  created,  a  medical  examination  was  made  of  all  persons 
who  could  be  discovered  as  having  attended  either  the  B.  wake  or  the  wake  of  the  child  M. ,  with 
the  following  results  : — 

1.  Discovered  ill  in  their  own  houses — 

(1)  Two  children  (T.),  sons  of  Mrs.  T.  already  referred  to.    One  of  tliese,  on  closer 

observation,  proved  not  to  be  plague, 

(2)  A  girl  (M'K.),  residing  at  57  Thistle  Street. 

2.  Removed  to  reception-house. 

In  all,  over  100  persons,  who  were  not  obviously  ill,  but  had  visited  one  or  other  of  the  houses  named, 
were  removed  to  the  reception-houses  for  observation,  and  four  of  tliem  have  since  sickened  (M., 
M'G.,  D.,  and  R.)    (For  dates  see  Table  which  follows.) 

Two  additional  cases,  F.,  77  Rose  Street  (admitted  29th  August),  and  C,  1  Well  Street,  Calton 
(admitted  30th  August),  were  afterwards  brought  under  notice  by  medical  practitioners,  suffering 
from  the  disease,  and,  after  examination,  removed  to  hospital.  C.  has  an  indirect  connection,  in 
respect  of  having  slept  in  a  house  next  door  to  that  of  the  B.  family  on  15th  August,  and  F.  is  a 
jobbing  shoemaker  living  in  the  adjoining  tenement. 

On  6th  September,  one  of  the  "contacts"  under  observation  displayed  symptoms  of  tenderness 
in  the  groin,  and  was  removed  to  hospital  for  observation.  Phlebitis  of  the  femoral  vein  there 
developed  and  cleared  up  the  suspicion.  On  the  following  day  a  child  was  removed  from  Crookston 
Street  with  symptoms  suggestive  of  pestis  minor,  and  a  history  of  indirect  association  with  one  of 
the  wake-contacts.  In  8  of  these  cases  the  diagnosis  of  plague  has  been  microscopically  verified. 
From  the  following  Table,  a  family  (U.),  from  57  Thistle  Street,  is  presently  omitted,  because  of 
some  uncertainty  regarding  the  clinical  importance  to  be  attached  to  their  symptoms  : — 


GLASGOW.— PLAGUE  CASES,  WITH  DATES  OF  SICKENING  AND  EXPOSURE  AS 

PRESENTLY  KNOWN. 

Deaths  at  Home  [assumed  to  be  due  to  Plague). 


Name. 

Address. 

Sickened. 

Died. 

Wake  lield. 

(1)  Baby  in  B.  Family, 

(2)  Mrs.  B., 

(3)  Tina  M.,i 

71  Rose  Street, 
57  Thistle  Street, 

Aug.  3rd, 
3rd, 
,,  19th, 

Aug.  7th, 
„  9th, 
„  21st, 

Aug.  9th  and  10th. 
„   21st  and  22nd. 

1  Attended  the  B.  wake. 
Cases  Removed  from  their  Homes. 


Name. 

Age. 

Address. 

B.  (1)  James  B., 
B.  (2)  Pat.  F., 

60 
56 

71  Rose  Street, 
77 

B.  (3)  John  C, 

24 

1  Well  St.,  Calton, 

B.  (4)  Mrs.  T., 

(5)  James  T.,^ 

(6)  Dennis  T., 

9 

6 

23  Oxford  Lane, 
)  ? 

B.  (7)  Mrs.  M., 
B.  (8)  Pat.  M. 
(9)  Wm.  M., 

3 

57  Thistle  Street, 
)) 

(10)  Annie  M'K.. 

12 

B.  (11)  Thomas  H., 

12 

6  So.  Coburg  St., 

Sickened. 


Aug. 


Removed  to 
Hospital. 


12th, 
13th, 

Aug.  27th, 
,,  29th, 

17th, 

,,  30th, 

12th, 
21st, 
21st, 

„•  25th, 
,,  29th, 
,,  29th, 

20th, 
22nd, 
23rd, 

, ,  2oth, 
,,  25th, 
,,    25  th, 

28th, 

,,  29th, 

23rd, 

,,  29tli, 

Where  Exposed,  <fec. 


Wife  died  9th  August. 
A  jobbing  shoemaker  near 

B.'s,  but  definite  contact 

not  traced. 
Slept  in  house  adjoining 

B.'s  on  13th  August. 

Relations  and  visitors  at 
B.'s. 

(Attended  B.'s  wake,  child 
died  at  liome  on  21st 
August  (see  above).  Pat. 
M.  died  in  hospital. 
At  B.'s  wake,  and  after- 
wards in  house. 
At  M.'s  on  20th  Ausuyt. 


B.  =  Bacillus  obtained. 


2  James  has  not  plague,  but  a  gluteal  abscess. 


34 


Cases  among  "Contacts"  and  Sickening  in  Reception-house. 


Name. 

Age. 

Address. 

Sickened. 

Removed 
to  Hospital. 

AVliere  Exposed,  &c. 

(12)  Jane  M., 

(13)  Arch.  D., 

(14)  Patrick  M'G., 

(15)  Agnes  R., 

14 

18 

Aug.  29th, 
,,  29th. 
„  31st, 
,,  31st, 

At  M.'s  wake. 

)  1 
)  3 

Indirect  Contact. 

(16)  May  M'L., 

18 
months. 

154  Crookston  Street, 

Aug.  26th, 

Sept.  6th, 

Indirect  contact  (?) 

Note. — This  Table  does  not  include  a  family  (D.)  removed  from  57  Thistle  Street  on  August 

At  the  present  moment  it  is  impossible  to  make  any  definite  statement  as  to  the  source  of  the 
infection  of  the  first  two  cases  in  the  B.  family.  The  husband  of  the  elder  patient  was  in  the  service 
of  a  local  shipping  company  as  a  dock  labourer,  and  employed  by  them  at  their  wharves  on  the  south 
side  of  the  river.  He  was  engaged  exclusively  on  vessels  trading  between  home  ports.  His  illness 
only  developed  after  his  wife  died,  and  may  be  regarded  as  resulting  from  this  or  from  his  grandchild's 
illness.  His  daughter,  the  mother  of  the  child  who  first  died,  is  said  by  her  father  to  have  been  ill 
for  two  days  shortly  before  her  child  sickened.  She  now  displaySj  one  month  afterwards,  very  slight 
enlargement  of  the  cervical  and  axillary  glands  on  both  sides,  which,  compared  with  the  glands  of  a 
normal  girl — definitely  non-infected — of  corresponding  age,  indicate  some  irritative  process  recently 
active.  This  girl,  meanwhile,  stoutly  denies  any  illness,  and  it  must  be  remembered  that  she  had 
nursed  her  baby  for  some  time.  The  father  of  the  child  is  an  iron-worker  in  constant  employment. 
He  has  had  no  illness,  and  presents  no  evidence  of  glandular  enlargement. 

[Note. — Since  the  above  was  written  one  case,  clinically  recoguisable  as  plague,  and  verified  by 
bacteriological  examination,  was  admitted  to  hospital  on  Sunday,  9th  current,  and  a  girl,  whose 
illness  goes  back  to  the  28rd  of  August,  was  removed  the  following  day.  These  are  not  traceably 
connected  with  each  other,  or  with  any  of  the  earlier  wakes,  and,  taken  in  connection  with  the  death 
in  Govan  during  the  last  week  of  August,  must  be  regarded  as  indicating  that  a  strain  of  infection, 
has  obtained  admission  to  the  population  from  which  each  of  these  four  groupings  directly  arise. 

The  means  by  which  this  strain  of  infection  has  gained  access  is  presently  conjectural  only  ;  but 
it  is  to  be  remembered  that  pestis  minor,  or  the  ami)ulant  form  of  plague,  is  a  disease  characterised 
by  few  symptoms,  and  must  frequently  escape  detection.  In  this  connection  the  occurrence  of  several 
cases  of  sickness,  with  glandular  affection,  among  the  crew  of  a  ship  while  in  port  here  in  May  last, 
is  being  inquired  into.  Any  opinion  as  to  the  character  of  an  illness  described  after  such  an  interval 
can  only  be  formed  after  very  carefid  scrutiny  of  the  facts  ;  but  it  is  obviously  most  desirable,  in  the 
interests  both  of  the  shipping  and  the  community,  that  all  such  sicknesses,  when  they  occur,  should 
be  promptly  brought  to  the  notice  of  the  Local  Authority.] 

*  ■)(■  *  *  *  «  -x-  *  -if  * 

(See  p.  22.) 


SECOND  INTERIM  REPORT  BY  MEDICAL  OFFICER  OF  HEALTH, 
SUBMITTED  TO  THE  HEALTH  COMMITTEE  ON  24th  SEPTEMBER,  1900. 

Since  19th  September  no  case  of  plague  is  known  to  have  occurred  among  our  own  population, 
the  admission  to  hospital  on  the  20th  being  that  of  a  male  patient  from  Govan,  who  had  been  sent  to 
one  of  the  general  hospitals  for  treatment  for  wh;it  was  regarded  as  a  surgical  affection,  aud  was  from 
thence  transferred  to  Belvidere. 

The  following  table  continues  the  record  of  admissions  since  those  contained  in  the  report  for  last 
fortnight : — 


Name. 

Address. 

Date  of 
Sickening. 

Removed 
to  Hospital. 

(1)  Chas.  M'M., 

52  Dale  Street, 

Sept.  8th, 

Sept.  9th, 

(2)  RosinaM., 

23  Florence  Street, 

Aug.  23rd, 

,,  10th, 

(3)  Mrs.  B. , 

81  Cubie  Street, 

Sept.  13th, 

„  14tli, 

(4)  Ellen  R., 

(5)  George  H., 

(6)  Mrs.  M., 

Belvidere  Hospital,  • 
248  Mathieson  Street, 
57  South  Goburg  Street, 

,,  13th, 
Vth, 
,,  14th, 

„  14th, 
, ,  14th, 
,,  15th, 

(7)  Mary  M., 

(8)  Robert  M., 

(9)  Mrs.  M., 

(10)  Mrs.  G., 

(11)  Mary  G., 

(12)  Wm.  W..1 

52  Dale  Street, 

21  Robert  Street,  Govan, 

,,  14th, 
,,  14th, 
,,  13th, 
,,  18th, 
,,  18th, 
,,  1st, 

.,  15th, 
,,  16th, 
.,  16th, 
19th, 
,,  19th, 
,,  20th, 

Where  Exposed. 


Slept  on  a  bed  on  which  a 
neighbour  had  died  from 
"pneumonia"  on  2Sth 
August,  and  was  buried 
1st  September. 

Worker  in  a  hair  factory, 
but  with  no  known 
association  with  other 
cases. 

Wife  of  a  clothes  collector 
in  Sanitary  Wash-house. 

Cleaner  in  Plague-ward. 

See  Note  in  text. 

A  married  daughter  of  the 
other  Mrs.  ,M.  admitted 
16th  September. 

See  details  in  text. 

Sister  and  niece  of  C.  M'M, 
above.    See  note  below. 


'  Admitted  through  one  of  General  Hospitals. 


35 


In  addition  to  the  above,  five  persons  were  removed  to  hospital  during  the  fortnight  presenting 
symptoms  wliich  at  the  time  gave  rise  to  a  suggestion  of  plague.  In  four  of  these  the  further 
development  of  symptoms  enabled  them  to  be  set  aside  definitely  as  not  plague,  vv^hile  one  case  still 
remains  under  observation. 

Relationship  op  Cases.  • 

(1)  C.  M'M.  has  no  relation  which  can  be  traced  with  earlier  known  cases.  A  neighbour  had 
died  on  28th  August  of  "  pneumonia,"  and  was  buried  on  1st  September.  After  the  death  the  bed  on 
which  he  had  lain  was  transferred  to  M'M.'s  house,  and  was  used  by  M'M.  and  his  wife. 

(10)  Mrs.  G.  is  a  sister  of  this  patient,  and  sickened  under  observation  on  18th  September.  On 
lOtli  September  she  had  been  given  subcutaneously  10  c.c.  Yersin's  serum.    A  mild  attack. 

(10)  Mary  G. ,  aged  six  years,  a  daughter  of  last  patient,  also  sickened  on  18th  September. 
Because  of  her  age  and  some  passing  indisposition  an  injection  of  Yersin's  serum  was  not  given.  Her 
attack  has  proved  fatal, 

(2)  Rosina  M.  sickened  23rd  August,  a  swelling  in  the  groin  being  observed  by  herself  on  26th. 
She  had  no  regular  medical  attendance,  and  the  nature  of  her  illness  was  not  recognised  till  10th 
September. 

(3)  Mrs.  B.,  the  wife  of  an  employee  of  the  department  engaged  in  the  work  of  collecting  infected 
clothing.  He  must  therefore  be  regarded  as  the  transmitter  of  the  infection  to  his  wife,  and  for  this 
reason  the  occurrence  will  require  the  most  rigid  investigation.  For  several  years  it  has  been  under- 
stood that  the  collectors  were  provided  with  overalls  to  protect  their  clothing,  and  to  be  worn  only 
when  at  work.  It  now  appears  thafwhat  they  wear  is  not  an  overall  suit,  but  simply  clothing  of  a 
white  material.  His  wife  now  makes  the  definite  statement  in  hospital  that  he  regularly  came  home 
in  this  suit,  and  occasionally  wore  a  coat  to  render  it  less  conspicuous.  For  the  present  I  have 
recommended  that  after  each  remnval  of  plague  clothing  the  collector  must  bathe  and  change  his 
entire  clothing  before  leaving  the  wash-house. 

(4)  Ellen  R.,  a  ward  cleaner,  employed  in  the  plague-ward,  and,  like  all  tlie  others  whose  work 
brings  them  into  contact  with  these  cases,  she  received  an  injection  of  10  c.c.  Yersin's  serum.  This 
was  on  3rd  September,  and  she  sickened  on  12th,  her  illness  being  of  the  mildest  possible  description. 
The  micro-organism  has,  however,  been  recovered  from  an  affected  gland. 

(5)  George  H.,  46  years,  boot-top  fitter,  residing  at  248  Matliieson  Street,  was  admitted  to 
hospital  on  12th  instant,  and  died  on  the  following  daj'.  Examined  post  ■mortem,  this  was  found  to 
have  resulted  from  plague.  He  sickened  on  8th  September.  His  illness  was  associated  with  earlier 
illnesses  in  a  family  (G.)  living  at  the  same  address.  Mrs.  G.  was  removed  to  hospital  on  1st  instant, 
and  died  on  the  4th  of  suspected  typhus,  whilst  her  daughter,  at  the  time  of  her  removal,  was 
discovered  dead  in  their  house.  In  Mrs.  G.'s  case  the  question  of  plague  was  considered,  because 
she  was  known  to  have  been  a  visitor  at  tlie  family  B.  when  the  earlier  cases  occurred  ;  but  the 
diagnosis  held  in  suspense.    On  pont-moriem  examination  the  evidence  was  still  held  as  inconclusive. 

(6-9)  M.  Family. — A  mother  and  three  children,  one  of  whom  was  married,  formed  one  house- 
hold, in  which,  we  were  informed  by  neighbours,  cases  of  illness  were  occurring.  They  have  an 
indirect  association,  through  a  "contact,"  who  visited  them  frequently,  with  the  family  T.,  of  23 
Oxford  Lane,  and  on  22nd  August  a  daughter  of  the  family,  named  Kate,  aged  14  years,  sickened, 
and  died  on  the  28th  August,  the  cause  of  death  being  certified  as  "pneumonia."  Tlie  friends  now 
describe  her  illness  as  having  been  accompanied  by  painful  swellings  about  the  neck  and  arms. 

Putting  together  the  admissions  since  the  disease  was  recognised,  we  have  now  had  a  total  of 
27  admissions  from  definitely  recognisable  plague,  and  of  these,  up  to  the  present  (26th  September),  5 
have  died  and  22  remain  under  treatment,  1  of  these  being  a  patient  from  the  adjoining  burgh. 

Mild  Nature  of  Attack  in  Many  Cases. 

Eight  only  of  the  cases  coming  under  treatment  in  hospital  can  be  classed  as  severe  attacks,  and 
of  these  5  have  died.  Seven,  on  the  other  hand,  are  of  extreme  mildness,  so  that,  save  for  their 
association  with  recognisable  cases,  a  suggestion  of  plague  would  never  have  been  raised. 

Twelve  fall  into  a  middle  class,  the  severity  in  individual  cases  ranging  between  the  severe  and 
mild  type  just  alluded  to,  but  with  a  tendency  to  mildness  rather  than  otherwise.  Indeed,  with 
regard  to  many  of  the  milder  forms,  the  question  of  diagnosis  is  no  easy  one.  V/e  are  familiar  in 
smallpox  outlireaks  with  the  extremely  modified  form  which  the  disease  may  present  in  persons  fairly 
well  protected  by  vaccination,  and  where  a  definite  history  of  exposure  alone  affords  a  means  of 
interpreting  aright  symptoms  which  would,  indeed,  rarely  be  critically  surveyed  were  the  persons  not 
under  observation  at  the  time. 

We  are  now  learning  practically  that  in  a  correspoading  way  plague  can  become  so  defaced  by 
mildness  in  its  form  of  attack  that  an  administrative  difficulty  of  no  inconsiderable  magnitude  is 
created.  Consequently,  I  believe  safety  lies  in  disregarding  the  query  which  constantly  haunts  those 
milder  forms,  and  dealing  with  the  surroundings  and  associates  of  the  suspect  as  if  no  doubt  as  to  its 
nature  existed. 

Yersin's  Serum. 

Over  60  persons  known  to  have  been  in  association  with  plague  patients  have  been  immunised  by 
subcutaneous  injection  of  Yersin's  serum  in  10  c.c.  doses.  Of  these,  2  have  sickened  of  a  very 
modified  form  of  the  disease. 


36 


Questions  of  dosage  and  the  method  of  administration  will  require  consideration  in  the  light  of 
the  partial  failures.  The  serum  is  much  more  powerful  as  a  curative  agent  when  injected  into  the 
veins  than  when  given  subcutaneously,  and  it  may  be  that  the  full  protective  value  for  "  contacts" 
is  only  to  be  obtained  by  a  similar  selection  of  site. 

Return  of  Contacts  to  the  General  Population. 
A  not  unnatural  degree  of  apprehensiveness  exists  regarding  these  people  on  their  discharge 
from  the  reception-houses.  It  may  serve  to  allay  this  if  it  is  explained  that  when  they  are  passed 
out  of  observation  by  the  department  they  are  themselves  free  from  any  risk  of  developing  the  disease 
to  which  their  contact  with  plague  patients  had  exposed  them,  their  clothing  has  been  disinfected, 
and  there  remains  nothing  about  them  save  the  memory  of  their  association. 

(See  page  23.) 

Notices  under  Glasgow  Police  Act,  1866,  Section  254. 
The  following  Notices  under  this  section  have  been  issued  : — 

Week  ending  8th  September. 

Dirty  Stairs,  Lobbies, 
Dirty  Houses.  and  Passages.  Total. 

35  42  77 

}Veek  rnding  loth  September. 
Dirty  Stairs,  Lobbies, 
Dirty  Houses.  and  Passages.  Total. 

176  79  255 

Week  ending  2i2nd  September. 
Dirty  Stairs,  Lobbies, 
Dirty  Houses.  and  Passages.  Total. 

244  14  258 


The  number  of  cases  of  overcrowding  discovered  in  the  defined  area  is  as  follows  ; 


Week  ending  8th  September, 
Week  ending  15th  September, 
Week  ending  22nd  September, 


Sanitary  Chambers, 
Glasgow,  24th  September,  1900. 


38  cases. 
27  cases. 
29  cases. 

A.  K.  CHALMERS. 


THIRD  INTERIM   REPORT  BY  MEDICAL  OFFICER  OF  HEALTH, 
SUBMITTED  TO  THE  HEALTH  COMMITTEE  ON  8th  OCTOBER. 

During  the  fortnight  the  following  deaths  from  plague  occurred  in  hospital : — 

Name.  Date  of  Death.  Date  of  Admission.  Reference  No. 

James  B.,      ...       September  24th,     ...      August      27th,      ...     No.  1  of  1st  Interim  Report. 
MaryG.,       ...       September  25tli,      ...     September  19th,      ...      No.  1 1  of  2nd  Interim  Report. 
iBabyM.,       ...       September  27th, 
Robert  M.,    ...       September  28th,      ...      September  16th,      ...      No.  8  of  2nd  Interim  Report. 
William  W.,  ...       October       6th,      ...      September  20th,      ...      No.  12  of  2nd  Interim  Report. 
•  Tliis  child  was  born  in  hospital  of  Mrs.  M.  (No.  6  of  2nd  Interim  Report)  on  16th  September,  and  died  on  27th, 
having  been  ill  for  three  days.    From  birth  it  was  a  delicate  child. 

No  case  is  known  to  have  occurred  among  the  population  during  the  fortnight,  but  among  persons 
brought  under  examination  the  following  may  be  selected  as  illustrations  of  illnesses  which  at  one 
part  of  their  course  at  least  present  symptoms  suggestive  of  plague,  and  require  careful  scrutiny 
before  exclusion  : — 

(1)  J.  M'C.  (male  adult),  sickened  on  27th  September  with  shivering  and  headache,  which  were 
followed  on  the  28th  by  pain  in  the  right  axilla.  On  examination  on  October  2nd  and  3rd,  there  was 
a  general  thickening  in  this  situation,  which  was  tender  on  pressure,  although  definite  glandular 
enlargement  in  the  axilla  could  not  be  discovered.  In  the  left  axilla,  however,  several  glands  were 
palpable,  but  were  not  tender  on  pressure.  He  was  removed  to  hospital  for  observation,  and  in  the 
course  of  the  following  day  an  abscess  of  a  distinctly  septic  character  appeared  in  the  right  axilla. 

(2)  Mary  M'F. ,  aged  13,  was  admitted  to  hospital  on  Saturday,  6th  October,  with  the  following 
history  : — 

"About  twelve  days  previously  a  swelling  appeared  in  the  right  groin,  which,  on  examination, 
was  not  painful  to  pressure,  and  had  not  given  rise  to  constitutional  disturbance."  Further  examina- 
tion of  this  gland  has  quite  definitely  excluded  plague. 


37 


(3)  On  6th  October,  a  boy,  M'E. ,  was  notified  as  suffering  from  "  fiever,  probably  typhus,"  and 
on  the  house  being  visited  it  was  learned  that  he  had  died  on  the  previous  evening.  A  history  of 
illness  beginning  suddenly  in  the  midst  of  apparently  perfect  health,  and  accompanied  by  vomiting 
and  high  fever,  with  rapidly  increasing  prostration,  followed  by  death  within  twenty-four  hours, 
aroused  suspicion,  which  was  strengthened  by  an  external  examination  of  the  body  and  the  discovery 
of  a  chain  of  enlarged  cervical  glands  on  both  sides  of  the  neck  and  in  the  left  axilla.  The  body  was, 
in  consequence,  removed  to  the  mortuary  at  Belvidere,  and,  with  the  father's  consent,  a  post-mortem 
examination  was  there  made  by  Dr.  Buchanan.  This  revealed  a  tonsillar  abscess,  with  a  widely 
distribiited  glandular  enlargement,  all  pointing  to  an  extreme  degree  of  susceptibility  to  septic 
poisoning,  to  whicli  the  death  can  be  attributed.    Evidence  of  plague  was  entirely  absent.^ 

Professor  Zabolotny,  of  the  Imperial  Institute  of  Experimental  Medicine,  St.  Petersburg,  who  in 
recent  years  was  a  member  of  the  Russian  Expedition  for  the  Studj'  of  Plague  in  India,  Arabia,  and 
Eastern  Mongolia,  and  who  spent  several  weeks  here  on  behalf  of  his  Government,  left  Glasgow  on 
Saturday  last,  and  was  good  enough  to  convey  to  me  his  conclusions  regarding  the  outbreak  here. 
As  these  will  be  of  interest  to  the  Committee,  I  reproduce  them  : — 

(1)  The  epidemic  in  (dasgow,  when  compared  with  that  of  India,  China,  and  Africa,  and  with 
those  in  Europe  of  recent  years  (Oporto,  Kolobowka),  is  of  the  most  mild  description. 

(2)  The  extension  of  the  epidemic  is  not  great,  and  the  mortality  quite  insignificant,  which  may 
be  attributed  to  the  medical  and  sanitary  measures  which  have  been  here  practised  with  so  great 
energy. 

(3)  For  the  most  part  one  meets  with  bubonic  cases  which  are  less  dangerous  from  the  point  of 
view  of  epidemiology  than  the  pneumonic  forms.  These  latter  are  excessively  contagious,  because 
the  sputum  of  the  sick  person  teems  with  plague  bacilli. 

(4)  As  in  the  bubonic  form,  the  sickness  does  not  spread  except  by  contact  with  the  skin,  the 
measures  of  isolation  and  cleansing  of  linen  and  clothing  play  a  most  important  role  in  prevention. 

(5)  For  persons  in  contact  with  the  sick  the  best  method  of  protecting  them  is  by  preventive 
injection  with  serum  (10  to  20  c.c. ),  as  is  here  practised. 

(6)  Treatment  of  the  patients  is  most  effective  when  the  serum  is  injected  in  large  doses  (60  to 
120  c.c.)  intravenously. 

(7)  The  post-mortem  examinations  of  fatal  cases  have  presented  a  picture  of  protracted  illness 
(suppuration,  nodules  pestewt,  mixed  infection),  and  not  that  of  an  acute  malady  terminating  fatally 
in  from  two  to  three  days. 

Notices  under  Glasgow  Police  Act,  1866,  Section  254. 
The  following  notices  under  this  section  have  been  issued  : — 

Week  ending  29th  September.                  Week  ending  6tli  October.  Grand  Totals. 

Apartments.                                         Apartments.  Apartments. 


2.         3.         4.  Total. 

1.  2. 

3. 

4.  Total. 

1.  2. 

3. 

4. 

Total. 

37      106      18       1  162 

35  75 

25 

4  139 

72  181 

43 

5 

301 

The  number  of  cases  of  overcrowding  discovered 

in  the  defined 

area  is  as 

follows 

Division. 

Overcrowded. 

Fined. 

Admonished. 

19 

54 

3 

19 

20 

25 

7 

21 

28 

10 

14 

22 

6 

4 

3 

113 

17 

43 

PLAGUE  IN  GLASGOW  IN  THE  17th  CENTURY. 

An  Extract  from  Memorials  of  the  Faculty  of  Physicians  and  Surgeons  of  Glasgow,  by 
Alexander  Duncan,  M.A.,  LL.D.,  Secretary  and  Librarian  of  the  Faculty. 

But  the  most  memorable  epidemic  of  the  plague  was  that  which  visited  Glasgow  in  1645-46,  and 
during  that,  and  perhaps  the  next  two  or  three  years,  made  terrible  havoc  amongst  the  townsmen. 
Almost  from  the  first  the  most  determined  efforts  were  made  to  stamp  out  the  disease.  Daily  house- 
to-house  visitation  was  eventually  adopted,  and  daily  reports  sent  to  the  magistrates  of  the  sick.^ 
When  the  measure  to  arrest  its  progress  failed,  it  was  resolved  to  have  recourse  to  the  old  expedient 
of  transporting  the  infected  out  of  the  town  to  the  muir.  This  muir  is  believed  to  have  comprised 
the  waste-lands  of  Sighthill,  Seggiehobn,  and  others  in  the  district  to  the  north  of  the  burgh. 
Intimation  was  to  be  made  "  be  touk  of  drum  that  na  manner  of  persone  goe  out  to  the  muir  quher 
the  foull  persones  are  without  leave  of  the  magistratis,  and  to  certify  that  those  who  on  the 
contraire  schall  be  put  out  to  the  muir  with  the  haill  families  they  are  in." 


'  See  Dr.  Buclianan,  p.  85. 

2  Minute  of  Council,  6th  November,  164G. 


38 


The  prevailing  terror  invaded  the  academic  precincts  in  High  Street,  the  University  authorities 
migrating  in  a  body  to  Irvine,  where  tlie  princinal,  the  regents,  and  the  bursars  of  the  College  were 
boarded  in  1645  and  part  of  1646.  Local  trade  was  almo5t  at  a  standstill.  Nearly  all  who  could 
leave  the  town  appear  to  have  done  so.  The  burgh  tollmen  and  tacksmen  had  to  beg  off  from  the 
payments  of  their  rents.  "  Gomperit  the  haill  takismen  of  the  mylne,  Laidells,  tron,  and  brig,  and 
intimat  to  the  Oouncell  that  in  respect  of  the  seikness  and  visitatioutie  they  could  get  naething  of 
ther  deuties."  The  buiial  of  the  dead  was  unaccompanied  by  the  usual  rites.  On  12th  December, 
1646,  it  was  ordained  "that  ther  be  na  melting  at  lykwakes  nor  efter  burrialls,  and  that  this  be 
intimat  by  touk  of  drume."' 

If  such  was  the  state  of  things  in  the  burgh,  who  can  imagine  the  horrors  of  the  plague-stricken 
banished  to  the  bleak  muir?  The  time  was  the  depth  of  winter,  their  only  shelter  was  "  ludges 
made  of  daills  and  spairs,"  with  straw  for  their  bedding.  By  20th  February,  1647,  the  visitation 
of  this  miserable  colony  had  assumed  a  sj^stematic  form.  "James  Robiesoune,  baxter,  is  maid 
choyce  of  to  be  visitour  of  the  muire  quhair  the  oncleane  fokes  ar,  and  to  set  doune  in  a  register  all 
occurantes  daylie  anent  the  iufectioune,  .  .  .  and  to  tak  notice  of  the  graves. ''  P'roquent  entries 
also  appear  in  the  treasurer's  accounts  at  this  time  ^  of  disbursements  for  supply  of  the  poor  on  the 
muir,  and  for  "coals,  peitts,  and  strae"  furnished  to  them.  On  17th  July  the  Councillors  are 
appointed  by  turns  for  a  week  to  visit  the  muir,  each  selecting  "an  other  honest  man,"  to  receive 
a  list  of  all  in  the  muir,  and  to  "disburse  to  James  Robiesoune  such  money  as  he  sail  requyre  to 
sustean  the  puire  on  the  muir,  and  to  viseic  the  muir  tweiss  or  thryiss  in  the  week,"  with  other 
necessary  duties  of  a  similar  kind.  Doctor  Rae,  possibly  a  physician  reputed  to  have  skill  in  the 
treatment  of  the  plague,  is  written  for,  but  apparently  does  not  come,  and  Dr.  M'Cluir  is  engaged, 
and  on  26th  July  got  ten  dollars  "  for  bygane  service  to  incouradge  him."  From  a  subsequent 
minute  it  appears  that  John  Hall,  the  principal  surgeon  in  Glasgow  at  that  period,  by  arrangement 
with  the  magistrates,  gave  his  services  to  all  and  sundry  gratuitously,  being  subsequently  paid  by 
them  as  well  for  inspecting  the  bodies  of  the  dead  as  for  his  care  of  the  living. - 

Within  the  burgh  it  would  appear  that  sanitary  measures  were  prosecuted  with  energy.  There 
is  a  curious  minute  of  10th  March,  1647,  in  which  the  bailies,  with  the  a,id  of  a  hired  man,  are 
charged  with  the  duty  of  removing  "suspect  fulyie."  In  these  days  the  honourable  office  of  the 
magistracy  was  clearly  very  far  from  a  sinecure.  One  noteworthy  result  of  the  compulsory  removal 
of  such  large  numbers  of  the  citizens  to  the  muir  was  that  the  magistrates  found  that  they  were 
obliged  pro  te'iipore  to  make  payment  of  their  plague  patient's  dobts.^  From  some  subsequent 
minutes  we  infer  that  some  amount  of  imposition  had  been  practised  by  the  "  unclean "  or  their 
friends.  Thus,  on  13th  March,  we  find  two  men  appointed  to  revise  "  the  compts  debursit  fur  honest 
men  the  tyine  they  closit  up  for  fear  of  infectioune."  Through  the  whole  of  the  summer  and  autumn 
of  1647  the  plague  appears  to  have  been  raging  with  virulence.  As  the  College  session  drew  near, 
it  was  necessar3'  to  make  some  arrangement  in  regard  to  a  temporary  local  habitation  till  the  plague 
abated.  Irvine  had  probabl\-  Keen  foun.i  inconvenient  on  a  -count  of  its  distance  from  the  city. 
Paisley  was  now  selected  for  the  purpose,  being  clear  of  the  pest,  though  its  past  reputation  as  a 
plague-haunt  was  not  good,  and  there  the  College  authorities  spent  part  of  the  winter.'' 

On  22iid  July,  1648,  the  pestilence  was  still  on  the  increase  ;  a  daily  inspection  of  everybody  in 
town  was  again  arranged  for,  and  a  proclamation  made  by  tuck  of  drum  prohibiting  the  frequenting 
of  taverns,  or  even  idle  wandering  through  the  streets.  From  the  Town  Cuuncil  Records  (for  12ch 
August,  1648)  we  learn  that  (ilasgow  was  now  in  sore  straits  for  money  for  the  maintenance  of  such 
numbers  of  the  stricken  poor.  Accordingly  they  agreed  to  call  in  a  sum  of  two  thousand  marks, 
collected,  but  not  expended,  some  years  before  for  a  similar  purpose,  and  now  on  loan  to  the  Earl 
of  Vv'igtowia.  It  was  not  till  the  following  year  that  this  terrible  visitation  of  plague  appears  to 
have  come  to  an  end  in  Glasgow. 

In  1665.  when  the  dreadful  scourge  made  its  memorable  inroad  on  London,  and  more  than 
decimated  the  population,  the  Town  Council  Records  (3rd  September)  show  that  the  people  of 
Glasgow  were  alarmed  and  on  the  watch.  In  the  previous  year  even  they  were  evidently  on  the 
alert,  the  Master  of  Works  having  been  ordered  to  repair  the  ports.  This  was  always  done  when 
they  had  reason  to  fear  an  outbreak,  as  if  the  magistrates  hoped  to  repel  the  impalpable  infection 
of  what,  with  emphatic  tautology,  they  call  "the  plague  of  pestilence "  from  their  gates  by  the 
same  measures  as  they  would  the  attack  of  an  armed  foe.  The  dreaded  visitor,  however,  did  not 
make  its  appearance  in  Glasgow  then  or  subsequently.  Its  sudden  disappearance  not  long  after, 
not  only  from  this  country,  but  from  Western  Europe  generally,  has  often  been  made  the  subject 
of  remark,  though  scarcely  explained.^ 


1  Minute,  29tli  May,  1647,  &c. 
-  Minutes  of  18th  September,  lfil7,  and  26th  August  and  2nd  October,  1648. 
3  Minute,  20th  February,  1647. 
*  Macltle's  History  of  Paisley,  p.  143.    See  also  Muniinenta  Universitatis  Glasguensis,  III.,  p.  537. 
\The  cause  of  its  sudden  decline  and  extinction  are  discussed  by  Creighton  (History  of  Epidemics  in  Britain, 

II.,  34  el.  seg.) 


39 


NOTES  REGARDING  SYMPTOMATOLOGY. 

By  John  Brownlee,  M.A.,  M.D.(Glas.),  D.P.H.(Camb.),  Physician- 
Superintendent,  Belvidere  Fever  Hospital. 

The  following  remarks  summarise  briefly  the  chief  symiDtoms  which  were  observed 
in  the  cases  of  plague  seen  in  Belvidere.  No  attempt  has  been  made  to  dissert  on 
the  symptoms  of  plague  in  general,  but  only  to  give,  as  far  as  possible,  an  accurate 
summary  of  what  was  actually  observed. 

Onset  of  the  Disease. — The  onset  of  the  disease  was,  in  general,  severe,  but  did 
not  differ  markedly  in  any  respect  from  that  of  other  specific  infectious 
disease.  In  only  one  case  were  there  any  prodromal  symptoms.  In  this  case 
slight  headache  and  malaise  seem  to  have  been  present  for  three  days  prior  to  the 
true  onset  of  illness.  The  onset  was,  in  general,  associated  with  severe  headache, 
and  often  with  rigor.  Severe  prostration,  and  pain  in  the  back  and  limbs,  were 
also  marked  features.  Vomiting,  though  not  frequent,  was  sometimes  a  very 
urgent  symptom,  and  in  one  case  lasted  through  the  whole  of  the  first  week  of 
illness.  Although  constipation  was  more  often  observed  than  diarrhoea,  yet 
the  latter  was  jjresent  with  sufficient  frequency  to  negative  the  diagnostic  value 
of  either  symptom. 

Fades. — Even  at  an  early  stage  of  the  disease  the  fades  was  very  characteristic. 
The  face  assumed  an  earthy  pallor,  which  was  more  marked  round  the  lips.  The 
expression  was  dull  and  heavy,  resembling  that  seen  in  tyjihus,  to  which  was 
superadded  a  look  of  anxiety,  which  was  most  noticeable  and  striking.  If  the 
patient  was  handled,  even  with  the  greatest  care,  the  brows  contracted,  and  the 
face  assumed  a  more  marked  appearance  of  apprehension,  which  was  further 
exaggerated  if  the  area  surrounding  the  bubo  was  touched.  This  was  very 
noticeable  even  in  patients  who  were  on  admission  quite  unconscious  to  all  outside 
impressions.  The  characteristic  fades  was  also  observed,  though  to  a  less  extent, 
in  nearly  all  the  cases  of  pestis  amhulams. 

Course  of  the  Temperature. — With  the  onset  of  the  disease  the  temperature 
seems  at  once  to  have  risen.  In  the  cases  which  came  under  observation  on  the 
second  day  of  illness,  with  one  exception,  the  height  of  the  fever  had  by  that  time 
been  reached.  In  severe  cases  a  high  and  somewhat  irregular  jjyrexia,  ranging 
from  102°  F.  to  105°  F.,  was  present,  usually  remittent,  the  morning  temperature 
being  from  one  to  two  degrees  lower  than  that  of  the  preceding  evening.  In 
general,  the  pyrexial  period  ended  by  crisis  or  rapid  lysis.  This  occurred  even  in 
cases  which  ultimately  terminated  flitally  from  secondary  sepsis.  The  crisis  took 
place  between  five  and  eighteen  days  from  the  beginning  of  the  illness  in  the 
untreated  cases.  In  the  milder  cases  an  early  fall  to  nearly  normal,  with  a 
secondary  recrudescence,  was  not  unusual.  In  those  in  which  secondary  infection 
was  present  from  the  beginning,  the  temperature  resembled  that  of  an  ordinary 
septicasmia.  In  the  very  severe  cases,  with  rapid  death,  it  remained  continuously 
high  until  the  fatal  issue. 

In  the  cases  treated  with  serum,  the  course  was  often  apparently  modified, 
as  will  be  found  specially  recorded  in  another  section. 

Bilboes. — -The  chief  sign  of  plague,  as  seen,  was  the  bubo.  All  the  cases 
treated  in  hospital,  with  one  exception,  which  will  be  discussed  separately, 
were  of  the  bubonic  type.  The  character  of  the  bubo  varied,  of  course, 
with  the  severity  of  the  case.  In  its  simplest  form  it  consisted  of  an  enlarged 
lymphatic  gland,  with  some  infiltration  surrounding  it.  The  skin  above  it  might 
be  freely  moveable.  Even  in  this,  the  simplest  form^  the  tenderness  of  the 
swelling  was  a  feature  which  was  so  marked  as  to  attract  immediate  attention  to 
its  presence.  The  limitation  of  the  bubonic  infection  to  one  gland  was,  however, 
very  unusual.  In  most  cases  the  groups  of  lymph  glands  which  fill  the  axilla  or 
the  groin  were  concurrently  affected.  In  severe  cases  the  implication  extended 
further,  and  the  involvement  of  adjacent  groups  of  lymphatic  glands  took  place. 


40 


In  these  instances,  though  the  surrounding  connective  tissue  was  markedly  infil- 
trated, yet  the  separate  glands  could,  in  general,  be  felt  on  palpation,  if  a  little  care 
were  exercised.  This  was,  of  course,  much  more  noticeable  in  the  groin  than  in 
the  axilla.  Over  the  affected  glands  the  skin  was  usually  reddened.  The  colour 
at  first  was  rose,  turning  afterwards  to  a  deeper  red,  and  finally  to  a  dusky  purple 
colour. 

As  the  bubo  advanced  there  was  frequently  an  exudation  of  serum  into 
the  neighbouring  connective  tissue.  This  was  often  slight,  but  in  some  cases 
there  was  a  widespread  oedema  into  the  area  of  which  the  bubo  was  the  central 
point.  In  one  case  this  oedema  extended  from  the  middle  of  the  abdomen  to  the 
foot.  In  one  other  case,  with  bubo  in'  the  groin,  although  the  oedema  surround- 
ing the  bubo  was  slight,  yet  marked  swelling  of  the  foot  on  the  affected  side 
was  observed. 

The  life-history  of  the  bubo  was  various.  In  the  slighter  cases  resolution 
took  place  without  breach  of  the  skin-surface,  but  in  the  majority  of  cases  the 
bubo  ruptured  spontaneously,  and  discharged  for  a  time  before  healing.  The 
discharge  was  sero-purluent,  flakes  of  pus  appearing  suspended  in  a  slightly-turbid 
serous  fluid.  Microscopical  examination  of  this  fluid  showed  degenerate  bacilli, 
both  free  and  included  in  the  leucocytes.  Cultures  made  from  the  discharge  were 
generally  sterile,  if  due  precautions  in  cleansing  the  skin  were  observed ;  at  most, 
a  few  colonies  of  skin-cocci  were  obtained.  In  only  one  instance  was  the  B.  pestis 
in  a  virulent  condition  recovered  from  a  bubo  which  had  spontaneously  ruptured. 
In  the  severe  cases  extensive  necrosis  of  the  glands  occurred,  involving,  also,  large 
areas  of  skin,  and  in  such  cases  it  was  impossible  to  prevent  secondary  infection. 
If  this  occurred,  two  results  were  noticed.  If  the  area  of  necrosis  were  small,  the 
process  remained  localised ;  while  if  the  area  of  necrosis  were  extensive — as  in  the 
case  of  J.  B. — a  widespread  extension  of  the  secondary  infection  occurred,  and 
death  resulted  from  septicaemia.  It  is  worthy  of  note  that  the  discharge  from 
the  ruptured  buboes  was  always  sero-purulent.  Even  in  slight  illnesses  it  was 
moderately  abundant,  and  only  slightly  mixed  with  pus  cells.  It  seemed,  in  fact, 
to  consist  largely  of  the  normal  lymphatic  drain  into  the  affected  glands.  It  was, 
in  the  case  last  referred  to,  very  abundant  indeed,  the  dressings  being  very 
frequently  soaked,  and  requiring  to  be  renewed.  In  a  number  of  the  cured  cases 
the  discharge  continued  for  some  weeks,  and  in  one  case  there  remained  for  a 
longer  time  a  small  lymphatic  fistula  discharging  clear  fluid. 

The  tenderness  of  the  buboes  was  a  feature  of  great  interest.  In  only  one 
case  was  this  symptom  absent.  In  some  patients  the  pain  on  touching  was  so 
great  that  even  the  movement  of  the  bedclothes  produced  considerable  distress.  It 
is  also  worthy  of  note  that  this  tenderness  disappeared  almost  completely  with 
the  fall  of  temperature,  and  although  the  swelling  was  some  time  longer  in 
showing  any  signs  of  subsiding. 

SJcin. — The  skin  in  all  cases  of  plague  observed  was  dry  and  hot.  Sweating, 
even  during  a  crisis,  was  not  a  constant  symptom — in  fact,  the  only  two  cases  in 
which  it  was  noted  were  those  in  which  doses  of  Yersin's  curative  serum  were 
administered.  (Cases  Nos.  9  and  19.)  Otherwise  it  was  only  noted  in  those 
patients  who  suffered  from  secondary  septic  infections. 

There  was  no  specific  rash  observed,  but  over  the  trunk  and  thighs,  in  a  certain 
number  of  the  severer  cases,  a  mottling  of  a  pronounced  character  was  noted. 
This  mottling  was  more  marked  than  the  subcuticular  mottling  of  t_yphus,  but  not 
so  noticeable  as  the  commencing  mulberry  eruption.  This  naottling  disappeared  as 
the  disease  progressed,  and  gave  place  to  a  general  dusky  hue  of  the  whole  cuticle. 
Petechige,  or  hsemorrhage,  were  not  observed  in  any  of  the  cases  which  were 
admitted  to  hospital. 

Desquamation  of  the  cuticle  was  not  infrequent.  It  began  towards  the  end  of 
the  second  week  in  a  punctiform  manner  over  the  trunk  and  limbs,  and  in  some  cases 
on  the  palms  and  soles  the  separation  of  the  cuticle  was  complete,  as  in  scarlet  fever, 


41 


the  jjatches  separating  being  tough  and  not  friable,  differing  in  this  resj^ect  from 
the  desquamation  which  often  accompanies  continued  fevers,  such  as  enteric. 

Alimentary  Tract. — The  lips  in  the  severe  cases  were  dry  and  cracked,  and 
occasionally  covered  with  sordes;  in  the  milder  cases  they  presented  nothing 
noteworthy. 

The  tongue  was  covered  with  a  white  fur,  and  was  usually  clean  round  the  edges. 
Even  in  severe  cases  it  was  often  not  dry.  In  the  worst  cases,  however,  as  the 
disease  progressed,  it  became  dry  over  the  dorsum,  and  covered  with  a  brown  fur. 
Even  in  these  cases,  however,  the  edges  usually  remained  moist. 

The  fauces  were,  as  in  most  fevers,  somewhat  congested,  but  presented  nothing 
noteworthy. 

Vomiting  was  not  a  common  but  sometimes  an  urgent  symptom  at  the  onset. 

The  bowels  were  in  general  constipated,  but  sometimes  the  attack  was  ushered 
in  by  severe  diarrhoea. 

The  plague  patients,  as  a  rule,  fed  well  during  the  attack. 

Heart  and  Circulatory  Organs. — In  the  acute  cases  the  heart  sounds  were 
soft,  but  murmurs  were  absent.  The  pulse  was  at  the  onset  full  and  bounding, 
but  rapidly  became  soft  and  easily  compressible.  The  rate  varied  very  much,  but 
in  general  it  was  lower  than  that  usually  seen  in  other  fevers  with  a  corresponding 
temperature.  In  the  severest  type  of  case,  however,  the  rate  frequently  evidenced 
a  very  profound  degree  of  cardiac  poisoning  (e.g.,  a  temperature  of  105'8°,  with  a 
pulse  of  134,  in  an  adult,  and  a  temperature  of  103'4°,  with  a  pulse  rate  of  152,  in 
a  child  of  six  years.) 

In  general  the  fatal  issue  was  accompanied  by  the  usual  quickening  of  the 
pulse,  which  is  the  symptom  of  cardiac  failure. 

Respiratory  Organs. — The  respiration  rate  in  plague  cases  was,  as  a  rule, 
strikingly  increased,  as  compared  with  that  usually  observed  in  other  cases  of 
fever,  apart  from  any  increase  in  pulse  rate.  The  normal  pulse-respiration  ratio 
of  1  to  4  was  almost  invariably  often  much  disturbed  without  any  lesion  being 
discoverable  in  the  lungs.  Sometimes  a  few  subcrepitant  rales  were  present  at  the 
base  of  the  lungs. 

Pneumonia  was  present  in  a  number  of  cases  as  a  complication,  and  in  these 
the  signs  present  were  those  indicating  that  the  lesion  was  patchy  and  not  lobar. 
Hypostatic  pneumonia  was  present  in  a  certain  number  of  the  fatal  cases  much  as 
it  is  in  any  other  continued  fever.  As  a  sequel  of  the  disease,  pleurisy,  without 
effusion,  was  observed  in  one  case. 

Spleen. — The  spleen  was  in  some  cases  enlarged,  but  not  markedly  so 
even  in  those  cases  in  which  a  blood  infection  was  proved  post  mortem.  In  no 
case  could  the  lower  border  of  the  spleen  be  palpated  below  the  costal  margin. 

Urine. — The  urine  showed  nothing  remarkable.  At  the  onset  it  exhibited 
the  usual  febrile  characteristics,  and  during  the  height  of  the  fever  a  trace  of 
albumen  was  sometimes  observed,  but  this  was  considerably  less  frequent  than  is 
the  case  with  such  diseases  as  typhus  and  pneumonia,  where  the  symptoms  are  of 
like  severity. 

Nervous  System. — The  most  marked  nervous  symptoms  were  delirium  and 
coma.  Even  in  the  protracted  cases  the  delirium  was  slight,  and  of  a  mildly 
delusional  character — the  patient  was,  in  general,  unaware  of  his  surroundings,  and 
often  thought  that  he  was  engaged  in  his  ordinary  avocations.  Muttering  was 
almost  always  present.  When  coma  occurred,  it  was  either  at  the  beginning  or  the 
end  of  the  illness.  If  the  former,  it  was  deep,  to  the  point  of  complete  unconscious- 
ness ;  but  it  was  noted  in  the  two  cases  in  which  this  was  observed  that  the  patient 
resisted  attempts  to  touch  the  region  in  which  the  bubo  was  situated.  A  curious 
feature  of  this  resistance  was  that  it  was  apparently  purposive.  The  patient  made 
the  same  movements  of  resistance  which  a  perfectly  conscious  person  would  make, 
showing  that,  although  the  higher  centres  were  completely  out  of  gear  yet  that  the 
brain-poisoning  was  not  so  complete  as  is  commonly  seen  in  the  coma  of  other 


42 


specific  fevers.  When  the  coma  supervened  at  the  close  of  the  diseases,  it  differed 
in  no  Avise  from  that  which  is  commonly  seen  ushering  in  the  lethal  exitus. 

Muscular  tremor  was  rare,  and  resembled  that  of  enteric  rather  than  that  of 
typhus.    Severe  hiccough  was  present  in  one  instance. 

Organs  of  Special  Sense. — Eye. — The  eyes  were,  in  general,  suffused,  but 
photophobia  was  not  observed.  The  pupil  was  slightly  dilated  in  most 
cases,  but  reacted  well  to  light.  Conjunctivitis  was  occasionally  present,  and  in 
three  cases  there  occurred,  in  the  third  week  of  the  diseases,  a  unilateral  severe 
injection  of  the  eye,  which  was  very  painful.  This  resisted  treatment,  and 
subsided  only  on  the  patient's  return  to  health.  From  such  inflammations  the 
plague  bacillus  was  not  recovered. 

Ear.- — Deafness  was  not  observed  as  a  symptom,  as  in  some  other  acute  fevers — 
e.g.,  typhus  and  enteric.  Otitis  media  occurred  once,  and  on  that  occasion  the  only 
organisms  found  were  the  bacillus  pyocyaneous  and  a  diplococcus. 

Pestis  Amhulans. — From  the  reception- houses  four  persons  who  seemed 
to  be  suffering  from  very  slight  attacks  of  plague  were  admitted,  so  slight 
that  had  they  come  under  observation  without  a  definite  history  of  contact 
they  would,  apart  from  a  bacteriological  examination,  be  quite  unrecognisable. 
The  importance  of  the  matter  is  further  enhanced  when  it  is  considered  that  in 
these  cases  the  buboes  were  so  small  that  to  put  a  needle  into  the  substance  of  the 
gland  was  a  most  difficult  matter.  The  general  symptoms  which  these  persons 
exhibited  have  been  as  follows : — In  the  onset  there  was  headache  and  malaise, 
associated  with  sickness,  while  A'omiting  was  only  occasional.  The  temperature 
was  only  slightly  raised — rarely  above  100°  F.,  and  sometimes  not  above  99'6° ;  the 
pulse  was  only  slightly  quickened,  and  the  rapidity  of  the  respirations  was  not 
markedly  altered.  The  face  was  heavy  and  drowsy-looking,  the  eyes  injected,  and 
the  tongue  furred. 

In  general,  in  addition,  the  patient  looked  much  more  ill  than  the  severity  of 
the  symptoms  warranted.  This  look  of  illness  usually  persisted  for  several  days 
after  the  symptoms  subsided.  The  seat  of  the  buboes  in  the  seven  cases  has  been 
twice  in  the  left  axilla,  three  times  in  thp  sub-maxillary  glands,  once  in  the  anterior 
cervical  chain,  and  once  in  the  sub-occipital  glands.  The  glands  have  been 
enlarged,  with  some  peri-glandular  infiltration,  and  in  one  case  reddening  of  the 
skin.  Tenderness  has  always  been  present,  though  not  so  markedly  as  in  the  more 
severe  cases  of  typical  plague,  and  this  tenderness  has  usually  appeared  on  the 
second  day  of  illness ;  it  subsided  after  two  or  three  days,  though  the  swelling  of 
the  glands  might  not  be  wholly  absent  even  after  a  fortnight.  The  clinical  picture 
is  fairly  constant,  though,  as  before  remarked,  the  illness  is  not  of  a  severity  to  be 
readily  diagnosed  unless  with  a  definite  history  of  plague  contact. 

One  of  these  cases  occurred  in  hospital  (E.  R.,  case  No.  21).  in  a  wardmaid 
who  was  in  attendance  in  the  pavilions.  As  they  were  for  plague,  she  had  received 
a  protective  inoculation  of  10  cubic  centimetres  of  Yersin's  serum  exactly  10  days 
previously  to  her  developing  an  illness  in  all  points  exactly  resembling  that  described 
above.  In  this  case  the  buboes  were  in  the  sub-occipital  region,  so  that  their 
puncture  was  rendered  more  easy  on  account  of  the  firm  tissue  which  lay  sub- 
jacent, and  did  not  involve  the  same  risk  as  in  other  cases  where  the  glands  affected 
lay  over  the  main  blood-vessels.  Typical  cultures  of  the  plague  bacillus  were 
obtained. 


Plate  A. 


Case  No.  9.— T.  H.   M.,  set.  15. 
To  shew  facies  of  the  plague  patients. 


Case  No.  6  — D.  T.  M.,  set.  6.  .Case  No.  1.— J.  B.  M.,  :pt.  GO. 

Right  inguinal  bubo,  forming  abscess  and  about  to  burst.  .    .  ftight  inguinal  bubo,  with  much  surrounding  infiltration  and  cedema. 

yamcs  Gilmour,  Printer,  Glasff07v. 


43 


Clinical  Histories,  with  the  Post-mortem  REPORTi^-iN  Fatal  Cases. 

*  Case  No.  1 .  — J.  B. ,  aged  60  years,  was  admitted  to  hospital  on  August  28th,  his  case  being  certified 
as  enteric  fever.  The  patient  sickened  on  August  15tli,  on  -wliich  date  he  was  suddenly  seized  with 
snivering,  nausea,  and  vomiting,  associated  with  severe  headache  and  slight  abdominal  pain.  The 
symptoms  from  their  onset  were  so  severe  as  to  make  him  take  to  bed,  where  he  remained  till  his 
removal  to  hospital.  From  August  25th  he  suffered  from  diarrhoea,  and  for  tlie  24  hours  preceding 
admission  he  was  delirious. 

On  adm'xnon  tlie  patient's  face  was  seen  to  have  the  same  dull,  heavy,  and  yet  anxious  Idok 
as  described  in  detailing  the  case  of  Patrick  Malloy.  The  pupils  were  moderately  dilated  and  the 
conjunctivae  were  slightly  injected.  The  tongue  was  coated  with  a  thick  greyish  fur  in  the  centre, 
while  the  edges  were  moist  and  clean.  There  was  no  congestion  of  the  fauces.  The  skin  presented 
the  same  mottling  noted  before  in  Patrick  M.,  with  the  difference  that  over  the  abdomen  it  was 
much  more  profuse.  In  the  right  groin  was  a  very  large  tense  red  and  (Edematous  swelling  occupying 
the  situation  of  the  verticle  group  of  glands.  This  swelling  was  exquisitely  tender  and  the 
tissues  surrounding  it  were  so  infiltrated  as  to  make  the  appreciation  of  individual  glands  by  palpation 
impossible.  The  lymphatic  glands  above  Poupart's  ligament  were  also  palpable  and  slightly  tender, 
while  the  skin  over  the  right  iliac  region,  though  not  reddened,  was  distinctly  oedematous.  Elsewhere 
the  lymphatic  glands  were  not  palpable.  The  temperature  was  I02'8°  F.,  the  pulse  was  soft  and  weak 
and  numbered  72,  while  the  respirations  were  at  the  rate  of  24  per  minute.  The  abdomen  was  slightly 
distended  and  rather  tense.  Ncjthing  noteworthy  was  detected  in  the  heart  and  lungs,  and  the  spleen 
and  liver  were  not  enlarged. 

Courf:e  of  Disease. — The  patient's  condition  was  all  along  precarious,  delirium  was  almost 
continuous,  although  slight,  and  at  no  time  violent.  The  pulse  was  feeble,  and  at  no  time 
during  the  first  10  days  of  the  disease.  Hiccough  was  present  from  August  30th  till  September 
8th,  though  not  in  a  distressing  degree.  Until  the  morning  of  September  2nd  the  temperature 
ran  a  febrile  course  varying  between  100'6°  and  103^.  On  that  morning  the  patient  had  a 
distinct  crisis  and  the  temperature  fell  to  97'6°,  and  there  was  improved  tension  in  the  patient's 
pulse  and  he  expressed  himself  as  feeling  better.  After  admission  the  redness  and  redema 
surrounding  the  swelling  in  the  groin  slowly  spread  until  it  extended  downwards  almost  to  the  mid- 
thigh  and  backwards  over  the  buttock.  At  the  same  time  oedema  without  redness  spread  from  the 
right  iliac  region  until  nearly  the  whole  abdominal  wall  pitted  readily  on  pressure.  This  was 
associated  with  a  distinct  increase  in  the  abdominal  distension.  The  inflammatory  process  reached  its 
height  on  Septemder  1st,  and  after  that  date  there  was  a  slow  but  distinct  subsidence  of  the  l  edness 
and  oedema  around  the  bubo.  The  oedema  of  the  abdominal  wall  disappeared,  but  there  appeared 
coincident  with  this  considerable  oedema  of  the  left  foot,  with  tendency  to  the  formation  of  pressure 
sores.  On  September  6th  a  secondary  fever,  due  to  the  suppurating  bul)o,  commenced,  and  the  tempera- 
ture ranged  continuously  from  100°  to  102°.  The  discharge  from  the  bubo  was  copious  and  serous,  and 
there  was  never  any  attempt  at  separation  of  the  sloughs.  Patient  gradually  became  more  feeble, 
remained  constantly  delirious,  and  died  on  September  24th  (Photograph  of  bubo,  Plate  A). 

Post-mortem  Examination,  26th  Septemher,  1900,  by  Dr.  R.  M.  Buchanan. 

External  Appearances. — The  body  is  considerably  emaciated.  On  the  trunks,  arms,  and  thighs 
there  is  an  unusually  profuse  freckling  of  the  skiu.  Over  Scarpa's  triangle  on  the  right  side  there  is  a 
large  ulcer  measuring  2^  inches  by  1§  inches.  Its  margin  is  sharply  defined,  and  its  floor  is  a  smooth 
yellowish-white  slough.  The  margin  at  the  inner  side  is  undermined  extensively,  and  a  small  sinus 
opening  is  discharging  pus  from  the  upper  end  of  the  ulcer. 

Cheit. — Both  lungs  are  firmly  adherent  posteriorly,  the  right  especially.  Both  are  hypera;mic 
anil  oedematous  posteriorly — the  right  more  than  the  left.  A  considerable  amount  of  purulent 
secretion  is  present  in  the  bronchial  tubes  of  the  right  lung. 

Heart. — The  myocardium  is  pale,  and  pri-sents  on  section  the  characters  of  cloudj'  swelling. 
There  are  no  ha3raorrhages  in  the  muscle  or  pericardium.  The  curtains  of  the  mitral  ami  aortic  valves 
present  much  fibrous  thickening. 

Liver. — The  liver  is  of  a  normal  size.    It  shows  slight  hyperceraia. 

The  spleen  is  slightly  enlarged,  and  its  tissue  firm. 

Kidneys. — The  capsule  of  each  kidney  is  removed  with  difficulty,  exposing  a  granular  surface 
with  a  number  of  cysts.  Numerous  small  yellow  foci  are  widely  distributed  over  the  surface  of  both 
kidneys.  They  have  the  appearance  of  small  abscesses,  but  are  fii-m  and  not  surrouuded  by  a  zone  of 
hypersemia. 

Stomach. — A  small  ulcer  is  found  near  the  pylorus  on  the  posterior  wall. 
The  in.testini'S,  pancreas,  and  bladder  present  nothing  remarkable. 

The  right  iliac  fossa  and  the  right  side  of  the  pelvis  are  occupied  by  a  large  partitioned  abscess,  a 
large  portion  of  which  impinges  on  and  involves  the  wall  of  the  bladder.  From  this  abscess  a  sinus 
runs  upwards  along  the  surface  of  the  psoas  muscle  to  the  right  side  of  the  lumbar  vertebrae,  and 
another  leads  from  its  lower  limits  downwards  to  discharge  from  the  ulcer  on  the  thigh.  The  abscess 
cavities  contain  creamy  pus  and  masses  of  necrotic  tissue.  A  purulent  infiltration  of  the  subcutaneous 
tissues  is  traced  nearly  half-way  down  the  thigh. 

The  lejt  ingumal  glands  show  some  enlargement,  but  no  evidence  of  inflammatory  action. 

A  pure  culture  of  bacillus  pestis  was  obtained  from  puncture  of  the  bubo  on  the  night  of  admission. 


*  The  Temperstni'4  Charts  of  those  cases  marked  with  an  asterisk  are  given  on  the  lithographed  plates  at  the  end  of  this 
Section. 


44 


*  Case  No.  2.— Mrs.  T.,  fet.  40,  admitted  August  2oth,  1900.— Certified  "Typhus  Fever." 
Patient  took  ill  ten  days  prior  to  admission,  the  onset  of  the  illness  being  severe  Headache, 
sickness,  and  vomiting  were  the  most  marked  symptoms.  Patient  was  three  months  pregnant,  and 
aborted  four  days  before  admission.  It  seems  to  be  quite  certain  that  at  this  time  she  made  complaint 
of  pain  in  the  left  groin,  but  when  this  first  appeared  could  not  be  definite!}'  ascertained,  as  patient 
was  very  ill,  and  lier  mental  condition  much  obscured.  On  admission  the  temperature  was  103  "2°  ; 
pulse,  128  ;  respiration,  44.  The  face  was  fluslied  and  heavy,  the  eyes  suffused,  and  the  tongue  dry. 
Tlie  pulse  was  very  soft  and  feeble,  resembling  that  of  typhus.  Nothing  worthy  of  record  was  dis- 
covered in  the  lungs.  The  discharge  from  the  vagina  was  scanty  and  sanguinolent,  M'ith  no  bad  odour. 
In  the  left  groin,  above  Poupart's  ligament,  there  was  a  large  swelling  of  about  4  inches  in  length  and 
2  inches  in  breadth,  which  was  very  tender.  The  skin  over  this  swelling  was  markedly  inflamed. 
Patient's  temperature  came  down  after  admission  by  rapid  lysis,  reaching  the  normal  on  the  morning 
the  crisis,  felt  fairly  well,  but  the  bubo  became  secondarily  infected,  and  she  had  a  continued 
of  August  28th.  From  cultivations  made  after  puncture  of  the  bubo  on  August  29th,  a  pure  culture 
of  B.  pestis  was  recovered,  after  an  unsuccessful  attempt  to  recover  the  bacillus  on  the  previous  day. 

.  .  The  patient,  after  the  crisis,  felt  fairly  well.  The  bubo  ruptured  spontaneously  on  September 
5th,  aud  discharged  a  sero-purulent  fluid.  Secondary  infection  of  the  bubo  occurred,  and  patient  had 
a  remittent  pyrexia  until  16th  September,  when  she  had  a  rather  severe  rigor,  and  examination  of  the 
chest  showed  the  presence  of  a  left- sided  pleurisy.  Thereafter  the  temperature  remained  highly 
febrile  for  two  daj'S,  after  which  it  resumed  its  previously  remittent  type,  the  pleurisy  at  the  same 
time  disappearing.  On  22nd  September  a  similar  dry  pleurisy  on  the  right  side  was  ushered  in  by 
rigor  and  rise  of  temperature,  which  lasted  for  three  days.  On  25th  September  pain  in  the  left  ear 
was  complained  of,  and  next  day  a  free  discharge  of  pus  through  the  external  auditory  meatus 
occurred,  after  which  the  temperature  fell  to  normal,  and  remained  steadily  so  until  dismissal.  By 
October  2nd  the  ear  was  completely  healed.  Cultivation  made  from  the  discharge  from  the  ear  showed 
marked  growth  of  B.  pyocyaneus  and  small  colonies  of  adiplococcus,  but  no  B.  pestis.  Convalescence 
was  good. 

*  Case  No.  3.— P.  F.,  admitted  to  Hospital,  29th  August,  1900.  Patient  took  ill  on  14th  Aiigust 
with  headache,  sickness,  and  vomiting,  diarrhcea,  and  extreme  malaise.  Two  days  later  he 
complained  of  pain  in  the  left  groin,  and,  examining  the  region  for  himself,  he  discovered  a 
swelling,  of  wliich  he  was  unable  to  state  the  exact  size.  The  diarrhoea  quickly  subsided,  whilst 
the  symptoms,  especially  the  Vomiting,  persisted  for  more  tlian  a  week.  The  swelling  in  his  left 
groin  steadily  increased  and  remained  intensely  tender  till  admission. 

On  admission,  temperature  was  103"  ;  pulse,  86 ;  respiration,  36.  The  patient  was  evidently 
acutely  ill,  the  face  drawn  and  anxious-looking.  The  eyes  were  suSused  and  the  pupils  slightly 
dilated.  The  skin  was  dry  aud  hot,  and  the  lips  tended  to  crack.  The  tongue  was  very  dry,  except 
at  the  edges,  and  there  was  a  brownish  fur  on  the  dorsum.  The  pulse  was  very  small  and  feeble. 
The  heart's  sounds  were  muffled.  Nothing  noteworthy  was  discovered  in  the  lungs.  In  the  left 
inguinal  region  was  a  large  swelling  over  which  the  skin  was  reddened  and  inflamed.  It  filled  up  the 
whole  groin,  and  on  palpation  was  found  to  be  very  hard  and  tender.  This  swelling  was  evidently 
glandular  in  origin,  and  the  tissues  in  its  neighbourhood  were  markedly  cedematous.  'J'here 
appeared  to  be  little  or  no  involvement  of  the  glands  above  Poupart's  ligament. 

During  the  first  few  nights  after  admission  patient  was  delirious,  and  remained  so  until  the 
temperature  fell  to  normal,  which  occurred  in  the  morning  of  3rd  September.  On  6th  September, 
slight  ichorous  discharge  made  its  appearance  at  the  site  of  a  puncture  made  in  the  bubo  on  the  night 
of  admission.  The  skin  at  this  point  began  to  necrose,  and  on  9th  September  the  sloughing  skin  was 
cut  away  to  admit  of  free  drainage.  During  this  time,  and  up  till  7th  September,  a  hectic  temperature 
was  maintained,  but  on  that  date  a  large  mass  of  necrosed  tissue  was  removed  from  the  groin,  after 
which  the  temperature  became  normal,  and  the  wound  granulated  until,  by  6th  October,  it  was 
completely  healed. 

On  6th  September  the  suffusion  of  the  right  eye  had  passed  away,  but  there  was  present  a  most 
intense  conjunctivitis  of  the  left  eye.  This  condition  was  very  troublesome,  and  did  not  disappear 
iintil  convalescence  became  fully  established. 

The  patient  was  left  greatly  enfeebled  by  his  illness,  and  convalescence  was  very  slow  (Photo- 
graph of  bubo,  Plate  A). 

Case  No.  4. — J.  C,  reported  page  65. 

*Case  No.  5. — Mrs.  M. ,  aged  40  years.  Admitted  to  hospital  August  25th.  Case  certified  as 
"  enteric  (?)." 

History. — The  patient  on  the  night  of  August  10th  was  at  the  wake  of  a  Mrs.  B.  On  admission 
the  patient  stated  that  she  was  first  seized  on  August  20th  with  shivering,  vomiting,  severe  headache, 
diairhcsa,  and  slight  pain  in  the  abdomen.  Next  day  she  felt  uneasiness  in  the  right  groin,  and  on 
examination  she  found  a  small  swelling  which  was  very  tender.  The  general  symptoms  became  more 
urgent  and  the  swelling  in  the  right  groin  increased  rapidly  in  size  and  in  tenderness.  During  the 
whole  of  her  illness  she  was  confined  to  her  bed. 

Condition  on  Admission. — The  patient  was  quite  intelligent,  but  looked  very  ill.  The  face  was 
slightly  flushed  and  wore  a  rather  anxious  expression.  The  pupils  were  moderately  dilated,  but  there 
was  no  injection  of  the  conjunctivas.  The  tongue  was  moist  and  only  slightly  coated  in  the  centre 
with  a  whitish  fur.  The  skin  was  hot  and  dry,  and  no  eruption  was  noticed  on  any  part  of  its  surface. 
In  the  right  groin  there  was  a  mass  evidently  composed  of  enlarged  lymphatic  glands  surrounded  by 


45 


inflammatory  tissue  to  the  extent  of  obliterating  the  fold  of  the  groiu.  T^e  skin  over  the  mass  and 
for  a  considerable  area  around  about,  particularly  laterally,  was  deeply  reddened  and  edematous. 
-Over  this  area  the  tenderness  was  extreme,  much  exceeding  that  usually  elicited  in  ordmary  infective 
buboes.  At  the  upper  border  of  the  swelling  deep  palpation  showed  that  numerous  glands  in  the 
deep  group  of  lymphatics  were  also  enlarged  and  tender,  but  there  was  practically  no  infiltration  of 
the  cellular  tissue  of  this  region.  The  skin  over  the  right  iliac  region  was  normal  in  appearance.  The 
glands  in  the  left  groin  and  in  the  axillary  and  cervical  regions  were  not  palpable.  Nothing 
notewortliy  was  discovered  in  the  heart  or  in  the  lungs.  There  was  no  enlargement  of  the  liver  or  of 
the  spleen.  The  temperature  was  102''  F.  The  pulse  was  soft  and  full,  numbering  92  per  minute. 
The  respirations  were  easy  and  numbered  28.  In  the  evening  the  patient  complaiued  of  very  severe 
headache  confined  to  the  frontal  region.  The  temperature  was  103 '4°  and  the  pulse  was  112.  while 
the  respirations  had  increased  in  rapidity  to  30  per  minute.  On  Awfiist  S6th  there  was  practically  no 
change  iu  the  patient's  condition.  The  morning  and  evening  temperatures  were  respectively  102"  and 
lOrS",  and  the  corresponding  pulse-rates  were  72  aud  80.  On  A  ugimt  27th  the  morning  and  evening 
temperatures  were  102°  and  100 ■4",  and  the  pulse-rates  were  76  and  80.  Though  the  respiration- 
rates  corresponding  to  these  were  respectively  30  and  26  there  was  no  evidence  of  any  pulmonary  lesion. 
August  2Sth  was  the  day  of  the  crisis,  the  temperature  falling  during  the  day  from  101  "4"  to  98 '6°,  the 
pvilse  showing  a  corresponding  drop  from  78  to  64.  At  the  same  time  the  headache,  which  had  been 
a  clamant  symptom  up  till  that  date,  disappeared,  and  although  no  obvious  change  had  occurred  in 
the  bubo  in  the  right  groin  the  tenderness  was  distinctly  less.  The  patient  also  expressed  herself 
as  feeling  much  better.  After  the  crisis  patient's  recovery  was  continttously  good.  The  bubo 
gradually  subsided  and  spontaneously  ruptured.  For  a  considerable  time  healing  was  slow  and  a 
thin  serous  discharge  continued  for  some  weeks  ;  from  this  the  bacillus  of  plague  was  not  recovered. 
She  left  well  on  October  6th. 

Bacteriological  Examination. — Four  hours  after  admission  a  puncture  was  made  into  the  glandular 
mass  in  the  right  groin  and  some  blood  was  withdrawn.  From  this  cover-glass  films  were  made  and 
glycerine  agar  tubes  were  inoculated.  Immediate  examination  of  the  films  after  staining  with  gentian 
violet  showed  the  presence  of  considerable  numbers  of  short  bacilli  morphologically  identical  with  the 
bacillus  pestis.  The  inoculated  tubes  were  incubated  at  37°  C,  and  24  hours  later  a  faint  white 
surface-growth  had  appeared  composed  of  small  translttcent  colonies.  Microscopical  examination  of 
cover-glass  preparations  made  from  these  colonies  stained  with  gentian  violet  showed,  as  in  the 
previous  case,  that  they  were  composed  of  short,  thick  bacilli  with  rounded  ends,  showing  for  the 
most  part  well-marked  bipolar  staining  and  occurring  frequently  as  diplobacilli.  When  treated  by 
Gram's  method  the  bacillus  was  decolourised.  The  appearance  of  the  cultures  and  stained  films  placed 
the  diagnosis  of  the  organism  as  bacillus  pestis  practically  beyond  a  doubt  ( Photograph  of  bubo, 
Plate  A). 

Case  No.  6. — D.  T.,  reported  page  65. 

Case  No.  7. — P.  M.,  aged  21  years,  admitted  August  25th,  1900,  his  case  being  certified  as 
"  enteric  (?)." 

History.  —Patient  was  living  in  the  same  room  as  his  sister,  who  sickened  on  August  19th,  and 
died  on  the  21st.  As  the  patient  was  not  in  a  condition  to  give  an  account  of  himself,  the  information 
was  obtained  from  his  mother,  who  volunteered  the  following  history  : — Until  three  days  prior  to 
admission  the  patient  appeared  in  his  normal  state  of  health.  On  that  date  (August  22nd)  he  suddenly 
experienced  a  shivering,  associated  with  sickness,  vomiting,  diarrhoea,  and  pain  in  the  abdomen. 
During  the  night  the  patient  was  evidently  delirious,  and  delirium  was  a  notable  feature  of  his  illness 
untd  the  time  of  admission.  With  the  exception  of  measles  and  whooping-cough  patient  had  suffered 
from  no  other  infectious  disease. 

Condition  on  Admission. — On  admission  the  patient  looked  extremely  ill.  He  was  nearly  in  a 
state  of  coma.  The  face  generally  was  of  a  greyish  colour  with  a  more  marked  circum-oral 
pallor.  In  spite  of  the  sttipor  in  which  the  patient  lay  the  expression  of  the  face  was  distinctly 
-anxious ;  there  was  marked  knitting  of  the  eyebrows,  the  ej^es  were  widely  open,  and  the  conjunctiv;e 
were  slightly  congested.  The  respirations  were  slow,  numbering  18  per  minute,  and  sighing.  The 
skin  generally  was  hot  and  dry.  It  was  covered  with  a  faint  purplish  mottling  most  marked  across 
the  lower  part  of  the  abdomen,  the  arms,  and  the  buttocks.  The  characters  of  this  eruption  somewhat 
resembled  the  sub-cuticular  mottling  of  typhus  fever.  The  tongtte  was  moist,  and  covered  in  the  centre 
with  a  thick  greyish  fur,  while  the  edges  were  clean  and  red.  There  was  no  congestion  of  the  fauces. 
There  was  in  the  upper  part  of  the  deep  cervical  chain  a"  swelling  composed  of  one  moderately  enlarged 
and  several  slightly  enlarged  lymphatic  glands.  The  tissues  surroitnding  these  were  markedly  infil- 
trated and  the  skin  was  reddened  and  oedematous.  Manipulation  of  this  swelling  was  evidently  very 
painful.  There  was  no  enlargement  of  glands  in  the  right  cervical  region  or  of  the  superficial  chain 
on  the  left  side.  The  right  axilla  was  filled  with  a  large  mass  evidently  composed  of  lymphatic  glands 
embedded  in  cedematous  cellular  tissue.  Here,  again,  the  skin  was  red  and  oedematous  and  movement 
of  the  arm  or  even  the  lightest  palpation  gave  rise  to  exquisite  pain,  evidenced  by  the  wincing  of  the 
patient  even  in  his  comatose  condition.  In  the  left  axilla  a  few  glands  were  slightly  enlarged,  but 
not  tender.  No  enlargement  of  glands  was  apparent  in  either  groin.  The  temperature  was  103  6, 
the  pulse  was  very  soft  and  easily  compressible,  and  numbered  128  per  minute.  The  lungs  revealed 
nothing  noteworthy  on  physical  examination.  The  cardiac  sounds  were  pure  ;  the  first  sound  was 
rather  weak.  The  abdomen  was  not  distended  and  was  neither  painful  nor  tender.  There  was  no 
apparent  enlargement  of  either  liver  or  spleen.    Exploratory  puncture  of  the  glands  of  the  axilla  was 


46 


performed,  and  an  immediate  examination  of  films  prepared  from  the  blood  withdrawn  revealed  the 
presence  of  a  considerable  number  of  bacilli  morphologically  identical  with  the  bacillus  pestis  of 
Kitasato. 

On  August  26th  the  general  condition  of  the  patient  remained  much  the  same,  though  the 
respirations  were  more  rapid,  numbering  28  per  minute,  but  the  local  conditions  had  undergone 
marked  alteration.  In  particular  the  Ij'mphatic  glands  on  the  left  side  of  the  neck  before  mentioned 
were  much  more  enlarged  and  the  superficial  glands  on  that  side  were  now  considerably  involved. 
Late  in  the  afternoon  the  glands  in  the  left  groin  were  easily  palpable  and  slightly  tender.  The 
cedema  in  the  right  axilla  was  more  extensive,  involving  the  anterior  border.  The  spleen  was  found  to 
be  enlarged  to  percussion,  though  not  palpable  below  the  costal  margin.  The  temperature  at  6  A.  M.  was 
102-4°  and  at  6  p.m.  104 '4°.  The  pulse  in  the  morning  was  112  and  in  the  evening  132,  and  even  softer 
than  on  the  previous  day.  On  this  evening  the  glycerine-agar  cultures  made  after  puncture  of  the 
glands  on  the  25th  and  incubated  for  24  hours  at  37°  C  were  examined.  There  was  a  faint  surface 
growth  composed  of  minute  whitish  translucent  colonies.  Cover-glass  preparations  were  made  from 
this  growth  and  stained  with  an  aqueous  solution  of  gentian  violet.  These  showed  the  presence  in 
pure  culture  of  a  short  bacillus  with  rounded  ends,  tending  to  run  in  pairs  and  showing  well-marked 
bipolar  staining.  The  bacillus  was  decolourised  by  Gram's  method.  The  character  of  the  culture 
and  the  morphological  appearances  of  the  bacillus  and  its  staining  reactions  confirmed  the  diagnosis 
made  from  the  examination  of  the  films  on  the  25th  that  the  organism  under  consideration  was.  the 
bacillus  pestis. 

On  August  27th  the  local  conditions  had  if  anything  advanced,  but  the  general  condition  of  the 
patient  was  rather  better.  There  was  a  little  less  mental  obtuseness,  thougli  it  was  still  with  great 
difficulty  that  he  could  be  got  to  show  his  tongue.  This  improvement,  however,  was  not  maintained. 
Bj'  mid-day  the  patient  was  cyanosed  and  the  pulse  was  notably  weaker.  He  sank  rapidly  and  died 
at  3.35  P.M. 

Post-mortem  Examination,  28tli  August,  J 900,  by  Professor  Muir. 

The  body  of  the  deceased  is  that  of  a  fairly  well  nourished  though  rather  slightly  built  man. 
There  is  a  distinct  swelling  in  the  right  axilla  and  also  a  well  marked  swelling  in  the  left  side  of  the 
neck.  In  the  left  groin  there  is  a  fairly  distinct  swelling  and  also  a  very  slight  one  in  the  right  groin. 
Weil  marked  hypostasis  and  diffuse  congestion  exist  in  the  region  of  the  neck. 

Thorax. — The  pericardium  contains  about  half  an  ounce  of  blood  stained  serum.  The  light  side 
of  the  heart  is  greatly  distended  with  dark  coloured  partially  clotted  blood,  while  the  left  side  is 
rather  contracted  and  empty.  The  cavities  are  of  normal  size  and  the  valves  appear  healthy.  The 
heart  muscle  is  rather  paler  than  normal,  but  not  specially  soft.  Over  the  apex  of  the  left  lung  are  a 
few  old  adhesions.  There  is  no  fluid  in  the  pleural  cavities.  The  lungs  show  marked  hypostatic 
congestion  and  also  some  collapse  but  no  pneumonia.  The  glands  at  the  root  are  not  visibly  affected. 
The  bronchi  contain  some  purulent  mucus.  The  right  lung  is  adherent  all  over,  especially  over  the 
lower  lobe.  There  is  an  old  cicatrix  on  the  chest  wall  over  this  part  (resection  of  rib  ?)  This  lung  is 
otherwise  in  a  practically  similar  condition  to  the  other. 

Abdomen. — The  peritoneum  is  normal.  The  spleen  is  enlarged,  weighing  12^  ounces,  the  increase 
being  chiefly  in  breadth.  The  consistence  is  softer  than  normal,  but  by  no  means  diffluent.  The  pulp 
presents  a  pale  and  mottled  appearance  and  the  Malpighian  bodies  are  small  and  distinct.  The  liver 
is  somewhat  swollen,  pale,  and  soft,  and  evidently  the  seat  of  cloudy  swelling  in  a  marked  degree. 
Both  kidneys  are  somewhat  swollen  and  soft,  owing  to  cloudy  swelling  of  the  cortex.  No  hemorrhages 
exist.  The  pancreas  is  slightly  swollen  and  softer  than  the  normal.  The  suprarenal  bodies  also  are 
rather  swollen  and  softened. 

Lymphatic  Glands. — The  glands  in  both  groins  show  enlargement  especially  in  the  vertical  gmup 
along  the  vessels.  They  are  somewhat  irregular  on  the  surface,  extremely  tense,  much  congested,  and 
show  small  hsemorrhagic  points.  The  substance  is  rather  softer  than  normal,  and  there  is  no  evidence 
of  suppuration.  The  enlargement  also  affects  the  glands  along  the  inguinal  vessels  and  some  of  them 
are  distinctly  hcemorrhagic.  The  retro -peritoneal  glands  along  the  aorta  show  great  swelling,  but  none 
of  them  reach  a  great  size.  In  the  right  axilla  there  is  a  large  swelling  almost  as  large  as  a  closed  fist, 
composed  of  a  mass  of  enlarged  glands  bound  together  by  infiltrated  tissue.  The  largest  single  glands 
are  about  the  size  of  a  small  plum.  They  are  of  a  dark  red  colour,  owing  to  the  diffuse  hfemorrhages 
into  their  substance,  and  here  and  there  show  partial  softei}ing.  The  periglandular  tissue  is  the  seat 
of  a  gelatinous  cedema  with  diffuse  hajmorrhages.  The  involvement  of  the  glands  extends  upwards 
behind  the  clavicle.  On  the  left  side  there  is  great  enlargement  of  the  cervical  glands  below  the 
sterno- mastoid  muscle,  where  there  is  a  large  irregular  mass  ;  the  axillary  glands  are  also  affected, 
though  to  a  much  less  degree  than  on  the  right  side.  The  amount  of  hemorrhage  is  extreme, 
some  of  the  glands  presenting  a  deep  crimson  colour  and  being  also  much  softened.  Here,  also,  there 
is  much  inflammatory  infiltration.  The  glands  in  the  upper  mediastinum  are  also  enlarged  and 
surrounded  by  inflammatory  oedema.  A  scraping  from  one  of  the  inguinal  glands  shows  enormous 
quantities  of  the  bacillus  pestis. 

Case  No.  8. — W.  M.,  aged  three  years,  57  Thistle  Street,  Glasgow,  was  admitted  to  the 
Belvidere  Hospital  on  August  25th.  This  child  is  the  son  of  Mrs.  M. ,  and  is  stated  by  his  mother  to 
have  become  ill  on  August  21st.  His  symptoms  appear  to  have  been  very  slight.  They  consisted 
solely  of  slight  pain  in  the  abdomen  and  general  malaise.  On  admission  the  temperature  was 
99'6°  F.,  the  pulse  was  lOG,  and  the  respirations  were  22.  The  child's  expression  was  dull  and  the 
face  was  very  pale.  There  was  a  markedly  enlarged  gland  in  the  submental  region  of  about 
the  size  of  a  large  marble.    This  gland  seemed  to  be  hard  and  adherent,  and  the  skin  above  it  was 


47 


slightly  red.  This  gland,  the  mother  distinctly  stated,  was  not  present  prior  to  this  illness.  The 
glands  in  the  axillae,  neck,  and  groins  were  palpable,  but  were  not  markedly  enlarged.  Those  in  the 
right  groin  were  the  most  obvious.  Nothing  noteworthy  was  detected  in  either  lungs,  heart,  liver,  or 
spleen.  On  August  26th  the  temperature  reached  100 '6°  but  without  any  aggravation  of  the 
symptoms  ;  since  then  the  temperature  had  been  normal  and  the  child  fairly  well.  The  submental 
gland  above  noted  decreased  steadily  in  size  till  at  the  end  of  10  days  it  was  barely  perceptible.  No 
bacteriological  examination  was  made  in  this  case. 

*Case  No.  9. — T.  H.,  aged  14  years,  was  admitted  to  hospital  on  August  29th,  his  case  being 
certified  as  "  enteric  fever  (?)."  He  sickened  on  the  23rd.  On  the  23rd  the  patient  was  seized  with 
headache,  retching,  and  pain  in  the  back  and  right  axilla.  He  was  fevered,  restless,  and  delirious 
at  nights  after  the  onset  of  illness.  The  pain  in  the  right  axilla  rapidly  became  worse,  and  was 
followed  by  pain  in  the  left  side  of  the  neck  and  in  the  right  groin. 

On  admission  the  patient's  face  was  flushed  and  the  expression  was  dull  and  heavy.  He  had  the 
same  apprehensive  expression  described  in  previous  reports.  The  pupils  were  dilated  and  the  con- 
junctivae were  fairly  clear.  The  lips  were  dry  and  there  was  well-defined  circum-oral  pallor.  The 
tongue  was  coated  in  the  centre  with  a  greyish  white  fur,  biit  was  clean  and  moist  at  the  tip  and 
edges.  The  skin  was  hot  and  dry  ;  it  presented  a  faint  mottling  which  was  most  marked  on  the  back, 
flanks,  and  buttocks.  As  the  patient  lay  in  the  dorsal  decubitus  the  right  thigh  was  slightly  abducted 
and  the  leg  was  semi-flexed.  There  was  a  general  enlargement  of  the  glands  in  the  groins,  the  axilla;, 
and  the  neck.  The  glands  in  the  right  axilla  and  the  right  groin  were  distinctly  the  largest  and 
exceedingly  tender.  No  complaint  of  pain  was  made  on  palpation  of  the  glands  of  the  left  groin,  the 
left  axilla,  or  the  neck.  The  skin  over  the  right  axilla  and  the  right  groin  was  slightly  reddened,  but 
was  not  oedematous.  The  temperature  was  104 'G"  F.,  the  pulse  was  140,  and  the  respirations  were  26. 
The  pulse  was  easily  compressible,  but  quite  regular.  The  respirations  were  easy.  Examination  of  the 
lungs  revealed  nothing  except  a  few  sub-orepitant  rales  in  the  left  baso-lateral  region.  On  auscultation 
over  the  cardiac  area  a  faint  systolic  murmur  was  heard  both  at  tlie  apex  and  in  the  pulmonic  region. 
The  abdomen  was  slightly'  tympanitic  to  percussion,  especially  in  the  right  iliac  region.  The  spleen 
was  enlarged  both  in  its  longitudinal  and  transverse  diameters. 

Course  of  Distaf-e. — Until  September  2nd  the  general  condition  remained  the  same.  There  was 
no  visible  increase  in  the  size  of  the  enlarged  glands.  He  was  \'ery  restless  at  nights,  having  delirium 
with  delusions.  Fever  was  high,  the  temperature  ranging  from  103°  to  105°.  The  pulse  was  rapid 
and  feeble.  Considering  the  stress  and  duration  of  the  fever  there  was  a  notable  absence  of  some  of 
the  commoner  symptoms  of  high  fever — viz.,  subsultus  tendinum  and  dryness  of  the  mouth  and  tongue. 
Headache  was  constantly  present.  On  August  31st  a  marked  injection  of  the  right  eye  was  observed, 
with  slight  prominence  of  the  eyeball.  On  September  2nd  a  Cijnsignment  of  Yersin's  anti-plague 
serum  was  received.  It  was  decided,  after  consultation,  that  this  patient  was  a  suitable  snbject  for 
serum  treatment.  Accordingly,  at  12  midnight,  an  intravenous  injection  of  15  cubic  centimetres,  and 
at  the  same  time  a  subcutaneous  injection  of  25  cubic  centimetres  of  the  serum,  were  made.  The 
patient  slept  well  after  the  injections,  and  perspired  freely  for  the  first  time  since  admission.  Next 
day  brought  no  remission  of  the  temperature,  but  the  buboes  in  the  right  groin,  which  had  been 
extremely  tender  on  the  previous  day,  could  now  be  touched  without  the  patient  experiencing  more 
than  a  slight  sense  of  pain.  A  like  lessening  in  the  tenderness  of  the  axillary  bubo  was  also  quite 
manifest.  A  fall  of  temperature  amoimting  to  4°  occurred  on  the  night  of  September  3rd,  and  since 
then  the  improvement  has  been  maintained.  On  September  9th  there  was  an  recurrence  of  pain  in  the 
right  groin,  associated  with  a  temperature  oscilating  between  98°  and  101°.  After  this  the  convalescence 
was  uninterrupted  and  good. 

A  pure  culture  of  the  bacillus  pestis  was  obtained  after  puncture  of  the  axillary  bubo  on  the  day 
after  admission  (Photograijh  to  illustrate  plague  facies,  Plate  A). 

Case  No.  10. — R.  M.,  reported  page  65. 

Case  No.  11. — W.  W.,  set.  42,  admitted  20th  September,  1900.  Patient  was  working  on  a  ship 
laid  up  for  repairs  on  return  from  India,  and  four  weeks  prior  to  admission  he  became  ill.  His 
general  symptoms  were  very  indefinite.  A  large  and  tender  bubo  on  the  left  groin,  which 
apparently  made  its  appearance  with  the  onset  of  the  general  symptoms,  was  the  chief  cause 
of  complaint.  This  was  incised  by  his  own  medical  attendant  a  week  after  its  appearance 
without  any  pus  being  found.  A  fortnight  later  it  was  again  incised,  but  again  no  pus 
was  found.  The  next  week  a  profuse  discharge  of  pus  from  the  incision  commenced,  and  patient 
was  sent  to  the  Western  Infirmary,  and  thence  to  Belvidere  on  the  suspicion  of  his  having  plague. 
On  admission  he  was  eviiiently  very  ill.  The  temperature  was  100°  ;  pulse,  88  ;  respiration,  50.  His 
intelligence  was  clouded,  and  he  was  unable  to  give  any  satisfactory  account  of  his  illness.  The  face 
was  livid  and  congested,  and  the  eyes  suffused  and  wandering.  The  tongue  was  dry,  and  coated  with 
a  yellowish-white  fur.  Nothing  abnormal  was  discovered  in  the  lungs.  In  the  left  groin  there  was 
a  large  swelling,  over  which  the  skin  was  very  livid,  and  which  was  bisected  by  a  lai'ge  vertical 
incision,  from  which  a  large  quantity  of  ichorous  fluid  was  exuding.  In  this  fluid,  on  direct 
microscopical  examination,  numerous  degenerateil  bacillary  forms  were  observed  free  in  the  fluid, 
and  also  contained  in  the  leucocytes.  No  definitely  typical  forms  of  B.  pestis,  however,  were  seen, 
and  none  could  be  isolated  by  culture.  The  bowels  were  constipated,  and  the  urine  contained  a 
trace  of  albumen. 


48 


During  llie  lime  this  patient  was  in  liospital  his  temperature  ran  a  coutinuous  hectic  course. 
He  was  delirious,  tending  occasionally  to  become  violent.  The  discharge  from  the  bubo  became  very 
profuse  and  ichorous.  On  •2nd  and  3rd  October,  55  cubic  centimetres  of  Yersin's  serum  were 
administereii  without  any  effect.  He  gradually  sank,  and  died  on  6th  October.  It  is  to  be  noted, 
however,  that  the  bacillus  pestis  was  recovered  post-mortem. 

*Case  No.  14. — A.  D.,  aged  18  years.  On  the  evening  of  August  28th  he  was  seen  on  account  of  his 
having  been  taken  ill.  The  patient  was  very  drowsy,  so  much  so  that  he  manifested  no  reflex  on  touching 
the  conjunctiva  with  the  finger.  There  seemed  to  be  no  suspicion  that  this  was  due  to  alcohol.  Head- 
ache, sickness,  and  vomiting  had  been  marked  and  severe  just  before  arrival,  but  had  temporarily 
subsided.  The  temperature  was  normal,  and  the  pulse  was  70.  All  the  glands  of  his  body  which  were 
accessible  to  palpation  were  examined  without  anything  abnormal  being  discovered.  Next  morning 
the  patient  was  somewhat  better,  but  he  was  kept  in  bed.  In  the  afternoon  a  recurrence  of  the 
headache  and  vomiting  took  place.  The  sub-maxillary  glands  in  the  left  side  were  complained  of  and 
fouud  to  be  enlarged.    The  temperature  was  99 '6°  F.    He  was  straightway  sent  to  hospital. 

On  admission  the  patient  had  that  heavy  and  obfuscated  look  which  has  been  already  described 
in  such  cases,  with  injection  of  the  conjunotivse  and  slight  dilatation  of  the  pupils.  The  sub-maxillary 
glands  were  considerably  enlarged  and  painful  on  palpation.  Next  morning  the  temperature  was  99°, 
at  which  elevation  it  remained  all  day,  but  a  consistent  normal  temperature  was  not  maintained  till 
the  seventh  day  of  the  illness.  The  pulse,  on  admission,  was  72,  and  had,  on  the  latter  date,  declined 
in  rate  to  50,  while  the  respiration  rates  were  respectively  24  and  20. 

The  tenderness  of  the  glands  persisted  for  about  three  days,  when  it  gradually  subsided,  but  the 
swelling  has  not,  even  at  the  date  of  writing  (September  18th),  completely  disappeared.  The  aspect 
of  illness  was  more  marked  and  lasted  longer  than  would  have  been  expected  from  the  local  conditions 
had  the  latter  been  due  to  ordiDary  causes.  As  possible  causes  of  the  condition  which  were  definitely 
excluded  may  be  mentioned  caries  of  the  teeth,  faucial  catarrh,  and  nose  or  ear  mischief.  Puncture 
of  the  gland  was  attempted  only  once,  as  it  immediately  overlay  the  deep  vessels  of  the  neck,  and  the 
cidtitre  proved  sterile.  It  is,  however,  open  to  doubt  whether  the  needle  actually  penetrated  the 
substance  of  the  gland. 

*Case  No.  17. — A.  R.,  reported  page  67. 

Case  No.  18. — G.  H.,  set.  46,  admitted  September  12th. — Patient  was  admitted  about  midnight. 
He  was  evidently  ill.  His  intellect  was  clear  but  his  expression  anxious.  He  made  no  complaint 
of  pain,  but  in  the  right  groin  a  marked  swelling  was  noticed  about  the  size  of  a  hen's  egg.  The 
tissues  round  about  were  infiltrated  and  the  skin  reddened.  It  resembled  the  plague  bubo,  as  we 
had  already  seen  it,  but  there  was  a  complete  absence  of  that  tenderness  which  had  been  present  in 
all  the  other  cases. 

As  patient  came  in  very  late,  and  was  much  exhausted  by  the  ambulance  drive,  he  was  not 
subjected  to  any  physical  examination.  He  collapsed  early  in  the  morning,  and  died  of  acute 
heart  failure. 

Temp,  on  admission,  103°. 

Post-mortem  Examination,  loth  September,  1900,  by  Dr.  R.  M.  Buchanan. 

External  Appearances. — A  well  nourished,  well  developed  body,  showing  a  small  number  of 
petechiae  scattered  over  chest,  abdomen,  and  thighs.  Over  the  upper  part  of  the  right  thigh  there 
is  some  fulness,  in  the  form  of  an  indefinite  diffused  slightly  oedematous  swelling,  over  the  centre  of 
which  the  skin  has  a  yellowish  tint. 

Chest. — The  -pericardium  contains  about  1  ounce  of  clear  fluiil.  The  heart  presents  subpericardial 
haamorrhage  over  the  base  of  the  left  ventricle,  and  its  muscular  tissue  shows  parenchymatous 
degeneration.    The  valvular  structures  are  normal. 

In  the  right  pleural  cavity  there  are  about  20  ounces  fluid,  and  about  10  in  the  left.  The  Imig.'i 
are  free  from  adhesion,  oedematous  and  hypertemic.  The  bronchial  glands  are  deeply  pigmented, 
enlarged,  and  very  hypersemic,  and  the  cut  surfaces  reveal  some  hasmorrhage. 

The  tissues  of  the  posterior  mediastinum  are  infiltrated  with  blood.  The  nech  is  the  seat  of  an 
extensive  extravasation  of  blood.  The  hemorrhage,  which  is  more  widespread  on  the  right  side  than 
on  the  left,  is  mainly  in  the  loose  intermuscular  connective  tissue,  but  is  also  evident  in  the  substance 
of  the  muscles,  especially  in  the  sterno-mastoid. 

The  cervical  lymphatic  glands  are  hypercemic,  and  considerably  enlarged. 

Abdomen. — The  spleen  is  "of  normal  size,  but  the  cut  surface  shows  the  pulp  slightly  soft  and 
hypersemic. 

The  liver  is  of  normal  size.  On  section  the  tissues  present  the  homogeneous  glancing  appearance 
of  cloudy  swelling  in  a  marked  degree.    The  gall  bladder  is  adherent  to  the  duodenum. 

The  Hdntys  are  large  and  very  hypersemic.  In  the  loose  adipose  tissue  of  the  hilus  of  each  kidney 
there  is  considerable  extravasation  of  blood. 

In  the  mucous  membrane  of  the  stomach  and  inte/tines  numerous  small  punctiform  haemorrhages 
are  found. 


49 

Glands. — The  vertical  set  of  the  right  ingximal  glands  has  undergone  enlargement,  and  the  con- 
nejtive  tissue  for  some  distance  around  is  cedematous,  the  fluid  near  the  glands  being  of  an  amber 
colour.  The  glands  are  firmly  matted  together,  forming  a  diffuse  swelling.  On  median  section  of 
this  swelling  it  is  seen  that  one  of  the  glands  has  attained  the  size  of  a  walnut,  while  the  others  are 
much  smaller.  They  are  all  intensely  hyperasmic,  with  numerous  haemorrhages,  giving  the  cut 
surface  a  brownish  red  mottled  appearance.  The  large  gland  is  also  somewhat  friable.  The  tissues 
immediately  around  the  glandular  mass  are  occupied  by  extravasated  blood  in  large  amount. 

The  iliac  and  pervertehral  glands  of  the  same  side  are  hypertemic  and  slightly  enlarged,  and  the 
same  is  to  be  said  of  the  inguinal  glands  of  the  left  side. 


■*  Case  No.  19. — C.  M'M.,  aged  30  years,  admitted  to  the  Belvidere  Hospital  on  September  9th. 
The  liistory  of  the  illness  obtained  from  his  friends,  and  afterwards  verified  by  himself,  was  to  the  effect 
that  for  about  a  week  before  his  admission  to  the  hospital  he  had  suffered  from  moderately  severe 
headache  and  slight  malaise,  but  he  continued  at  his  work  until  the  morning  of  September  8th,  when 
he  had  a  rigor,  with  increased  severity  of  the  headache  and  sickness,  although  vomiting  was  absent. 
By  noon  he  was  unconscious,  and  he  was  delirious  all  night,  and  very  violent. 

On  admission  tiie  patient  was  evidently  extremely  ill.    His  face  was  of  an  ashy  colour,  with  a 
more  marked  ring  of  pallor  round  the  mouth.    The  conjunctivce  were  slightly  injected  and  the  pupils 
were  contracted,  in  contrast  to  the  more  common  dilatation  observed  in  the  other  cases.     Tlie  tongue 
was  moist,  with  a  white  fur  on  the  dorsum,  but  not  markedly  injected.     The  temperature  was 
105"8°  F. ,  the  pulse  was  134,  and  the  respirations  were  40.     The  pulse  was  soft  and  compressible,  but 
full.    There  was  no  evidence  that  the  patient  was  in  the  least  conscious  of  his  surroundings.  When 
left  alone  he  tossed  restlessly  in  bed,  but  Ijetraycd  considerable  anxiety  in  his  face.    On  being  handled 
he  resisted  so  strongly  that  it  was  impossible  for  the  nurses  to  wash  him.     This  resistance  was 
extremely  marked  if  the  palpation  of  his  left  axilla  was  attempted.     In  this  situation  a  group  of 
glands  was  found  which  were  enlarged  and  acutely  painful.     (It  is  to  be  noted  here  that  the  move- 
ments of  resistance  made  in  opposition  to  the  examination  of  this  bubo  resembled  those  of  a  person 
conscious  of  his  actions,  and  not  the  purposeless  movements  usually  made  in  the  delirium  of  tj'phus  or 
enteric  fever.)     The  only  bubo  found  was  in  the  left  axilla;  elsewhere,  though  the  glands  were 
slightly  enlarged,  the  enlargement  was  no  more  than  is  often  met  with  in  healthy  persons.    The  other 
organs,  on  examination,  showed  nothing  worthy  of  note.     At  12  midnight  20  cubic  centimetres  of 
serum  (Yersm's)  were  injected  into  one  of  the  brachial  veins,  and  a  like  quantity  into  tlie  subcutaneous 
tissue  of  the  abdomen.     This  was  done  with  considerable  difficulty  owing  to  the  struggles  of  the 
patient.    At  the  end  of  six  hours  it  was  seen  that  the  patient  had  had  a  light  sweat,  and  that  the 
temperature  had  fallen  four  degrees.    The  pulse-rate  was  reduced  to  108,  and  the  respirations  had 
fallen  to  34.     The  pain  in  the  axilla  was  markedly  lessened,  and  the  surrounding  oedema  was  much 
less.     By  the  evening  the  glands  could  be  palpated  without  undue  resistance.     A  puncttire,  for  the 
purpose  of  completing  the  diagnosis,  was  made,  with  the  result  that  the  clinical  diagnosis  was 
confirmed  microscropically.    By  next  day  the  cultures  made  at  the  same  time  showed  typical  growths 
of  the  bacillus  pestis.    On  this  day  the  temperature  was  throughout  100°,  and  the  pulse  ranged  from 
64  to  7G.    The  patient  felt  quite  well,  and  desired  to  get  up.    On  questioning  him  it  was  found  that 
he  remembered  nothing  from  mid-day  on  Saturday  (September  8th)  till  the  evening  of  Monday  (the 
10th),  when  he  found  himself  in  the  hospital.     Since  the  latter  date  the  improvement  has  been 
const:int,  with  the  exception  of  a  rise  of  temperature  to  101°  on  the  evening  of  the  14th,  associated 
witli  a  sliglit  recrudescence  in  tenderness  of  the  glands  in  the  left  axilla,  wliich  subsided  on  the  next 
day.    The  pulse,  however,  was  still  weak,  and  the  heart-sounds  somewhat  toneless.    On  the  19th  and 
20th  there  was  a  rise  of  temperature,  associated  with  pain  and  discomfort  in  the  knee-joint  and  in  the 
left  thigh,  as  well  as  in  the  arms,  due  in  all  probability  to  the  serum  injected  on  the  9th.     From  this 
point  convalescence  was  interrupted. 


*  Case  No.  20.  —  Mrs.  B.,  ajt.  29,  admitted  14th  September.  The  illness  began  on  tlie  day  prior  to 
admission  with  severe  frontal  headache  and  rigor,  pains  in  limbs,  and  severe  pain  in  the  back.  There 
was  no  sickness,  vomiting,  or  diarrlioja.  On  the  morning  of  the  day  of  admission  pain  was  felt  in  tlie 
right  groin,  and  on  examining  this  region  she  perceived  a  small  lump,  which  was  very  tender  to  the 
totich.    Temperature  on  admission  was  lOO'S",  the  pulse  was  96,  and  the  respirations  were  32. 

On  admission  patient  did  not  look  very  ill,  but  the  face  was  somewhat  flushed  and  anxious.  The 
eyes  were  slightly  injected,  and  the  pupils  normal.  The  tongue  was  moist  and  slightly  furred.  The 
heart  and  lungs,  on  physical  examination,  showed  nothing  uoteworthy,  with  the  exception  of  a  few 
wheezing  rales. 

A  bubo  was  present  in  the  right  groin,  chiefly  involving  the  horizontal  chain  of  lymjjhatic  glands 
below  Poupart's  ligament.  The  vertical  chain  was  only  slightly  involved,  and  there  was  some  cedema 
in  the  surrounding  connective  tissue.  The  skin  in  Scarpa's  triangle  was  reddened.  This  bubo  was 
exceedingly  tender. 

Next  day  the  patient  was  somewhat  better,  and  as  the  temperature  had  fallen  no  serum  was 
given.  On  the  16th  the  temperature  was  still  normal,  but  the  symptoms  advanced  during  the  da}', 
and  in  the  evening  the  temperature  rose  to  101  ■2.  The  bubo  was  now  considerably  larger,  the 
connective  tissue  more  ojdematous,  and  the  skin  more  inflamed.  20  cubic  centimetres  of  serum  were 
therefore  injected  into  the  skin  of  the  abdomen.    Next  day  the  temperature  had  fallen  and  the  pain 


50 


in  the  bubo  considerably  abated.  On  tlie  morning  of  the  18th,  however,  the  local  conditions  had 
again  advanced,  with  extension  to  the  deep  inguinal  glands  above  Poupart's  ligament.  The  oedema 
was  much  increased,  and  the  redness  had  extended  down  the  side  of  the  thigh.  Consequently  20.cubic 
centhnetres  of  ssrum  were  injected  into  a  vein  of  the  right  arm.  Towards  evening  a  great  improve- 
ment in  the  patient's  condition  had  taken  place,  and  she  both  looked  and  felt  very  much  better.  Next 
day  the  temperature  was  normal,  and,  falling  to  slightly  sub-normal  in  the  evening,  remained  so. 
Improvement  was  rapid  ;  the  bubo  softened  and  ruptured  spontaneously  on  September  23rd.  Con- 
valescence was  good. 

A  pure  culture  of  the  plague  bacillus  was  obtained  on  admission  from  the  bubo.  On  rupture  the 
discharge  proved  sterile,  but  contained  many  degenerate  forms  of  bacilli,  some  being  free  and  others 
contained  in  the  leucocytes. 

Case  No.  21. — E.  R.,  aged  21  years,  was  a  wardmaid  in  the  wards  at  the  Belvidere  Hospital 
reserved  for  plague.  On  September  3rd,  as  a  prophylactic  measure,  10  cubic  centimetres  of  Yersin's 
serum  were  injected  subcutaneously.  This  produced  none  of  the  effects  often  resulting 
from  it,  such  as  urticaria  or  articular  pains.  On  the  13th  headache  and  pain  in  the  back 
were  complained  of,  and  nausea  was  also  present,  but  there  was  no  vomiting.  The  patient, 
however,  felt  very  unwell.  On  the  14th  the  headache  and  malaise  still  continued,  and,  in 
addition,  tenderness  and  stiflfness  in  the  back  of  the  neck  were  complained  of.  The  eyes  were  slightly 
injected,  and  the  face  was  flushed  and  its  expression  heavy.  The  tongue  was  slightly  furred,  but 
was  otherwise  normal.  Neither  diarrhcea  nor  constipation  were  present.  The  temperature  was 
normal  and  the  pulse  showed  nothing  noteworthy.  Behind  the  ears,  in  the  posterior  triangle  of  the 
neck,  there  was  on  each  side  a  markedly  enlarged  lymphatic  gland — that  on  the  left  side  being  of 
about  the  size  of  an  almond,  and  that  on  the  right  side  of  the  size  of  a  bean.  Puncture  was  made  into 
the  gland  of  the  left  side,  and  cover-glass  films  and  cultures  were  made.  These  showed  a  bacillus 
morphologically  indistinguishable  from  the  bacillus  pestis.  By  the  loth  the  tenderness  of  the  glands 
had  subsided,  and  since  that  date  they  have  been  decreasing  in  size.  The  patient  was  discharged 
well. 

*  Case  No.  22. — Mi-s.  M.,  20,  admitted  September  15th.  The  duration  of  the  illness  was  a  little 
doubtful,  owing  to  the  difficulty  of  obtaining  an  accurate  history  of  the  patient  from  her  friends. 
It  was,  however,  certainly  under  48  hours.  The  onset  had  apparently  been  very  severe  headache, 
pain  in  the  back,  diarrhoea,  and  great  prostration  being  the  most  marked  symptoms.  The 
patient  was  very  much  emaciated,  and  had  undergone  great  privation  for  some  time  prior  to 
admission.  The  face  was  pallid,  the  lips  dry  and  covered  with  sordes,  and  the  tongue  likewise 
dry,  with  a  brown  fur.  The  temperature  was  102"6 ;  the  pulse,  which  was  soft  and  rapid, 
numbered  140,  and  the  respirations  40.  The  patient  was  months  pregnant,  and  on  admission 
labour  was  already  in  progress.  The  only  phj'sigal  signs  observed  in  the  lungs  were  some  subcrepitant 
rales  at  both  bases.  There  was  a  large,  indurated,  and  very  tender  bubo  in  the  left  inguinal  region. 
No  rash  was  observed.  On  the  evening  of  admission,  20  cubic  centimetres  of  serum  were  injected 
intravenously,  and  20  cubic  centimetres  into  the  area  immediately  below  the  left  groin,  so  that  it 
might  drain  directly  into  the  bubo.  At  the  time  of  the  injection  the  temperature  had  fallen  to  99 '6, 
and  the  patient  was  much  collapsed.  At  4  a.m.  the  os  was  found  to  be  fully  dilated,  and  as  by  this 
time  the  patient's  general  condition  was  one  of  extreme  gravity,  instrumental  delivery  was  at  once 
effected.  The  child  was  born  asphyxiated,  and  after  much  trouble  was  resuscitated.  No  gross  lesion 
of  the  placenta  could  be  observed.  After  the  birth  of  the  child  the  patient  rallied  a  little.  The 
temperature  rose  to  103 '8  ;  the  tongue  and  lips  became  cleaner  and  moister,  and  the  patient  expressed 
herself  as  feeling  a  little  better.  On  September  16th,  20  additional  cubic  centimetres  of  serum  were 
injected  subcutaneously  into  the  abdominal  wall.  During  the  day  the  patient's  state  became  more 
and  more  grave,  and  she  died  at  11.50  p.m.  A  pvire  culture  of  the  plague  bacillus  was  obtained  from 
the  bubo  on  admission,  and  also  from  the  blood.  On  examining  the  bubo  after  death  no  plague 
bacillary  forms  which  did  not  bear  evidence  of  the  most  profound  degeneration  could  be  discovered, 
though  in  the  spleen  and  other  organs  of  the  body  typical  uncultured  forms  were  easily  seen. 

Post-mortem  Examination,  18th  September,  1900,  by  Dr.  R.  M.  Buchanan. 

Exttrnal  Appearances. — The  body  is  very  well  developed  and  well  nourished.  The  abdomen  is 
much  distended,  and  presents  the  greenish  discolouration  of  commencing  putrefaction.  With  this 
exception,  the  general  surface  of  the  body  is  pale.  There  is  a  slight  fiilness  observed  over  the  area 
of  Scarpa's  triangle  on  the  right  side. 

Chest. — The  heart  is  of  firm  consistence.  Over  a  small  area  at  the  apex  of  the  left  ventricle  there 
is  a  grotip  of  small  hemorrhages  under  the  pericardium,  extending  into  the  muscle  superficially. 
The  muscle  is  slightly  paler  than  normal,  and  a  slight  degree  of  cloudy  swelling  is  evident.  The 
valvular  structures  are  normal. 

The  lungs  are  hyperEemic  posteriorly  and  oedematous. 

Abdomen. — The  liver,  splf.cn,  and  hidneys  are  hyperoBmic. 

The  iiterua  in  its  form,  size,  and  position,  is  characteristic  of  recent  delivery.  It  is  firmly 
contracted,  and  the  internal  surface  is  lined  by  a  filmy  coating  of  blood  clot. 

Glands. — The  right  inguiral  glandn  are  considerably  enlarged.  The  vertically  disposed  glands 
■  together  with  a  retroperitoneal  (lower  iliac)  gland  form  a  chain  in  which  each  gland  is  very  similar  in 


51 


size  and  appearance.  On  section  they  are  found  to  be  fully  lialf-an-inch  in  diameter,  while  the  cut 
surfaces  are  of  firm  consistence,  intensely  liyperKmic,  and  darkly  mottled.  The  surrounding  tissues  are 
oedematous  but  free  from  haemorrhage.  The  retroperitoneal  gland  is  the  largest  of  tlie  group  in 
virtue  of  its  elongated  shape.  The  p7 evertebral  glands  in  the  same  side  are  also  notably  afl'ected.  The 
glands  generally,  including  those  of  the  mesentery,  are  slightly  enlarged  and  hyperfemic. 

*  C:ise  No.  23. — Mrs.  M.,  set.  41,  admitted  16th  .September.  The  history  of  the  illness  was  a 
little  difficult  to  obtain  accurately,  as  the  patient  was  considerably  out  of  sorts  for  some  weeks, 
but  it  jarobably  began  tvfo  days  prior  to  admission.  The  chief  symptoms  were  severe  headache  and 
general  malaise  ;  on  the  day  prior  to  admission  she  noticed  a  small  tender  swelling  in  the  right  groin. 

On  admission,  temperature  was  102 '4,  the  pulse  was  104,  and  the  respirations  were  24.  Patient 
complained  of  very  severe  headache.  The  tongue  was  dry,  and  the  face  very  anxious  looking.  In  the 
right  groin  there  was  a  small  bubo  about  the  size  of  a  pigeon's  egg  which  was  exceedingly  tender. 
There  was  also  some  induration  in  the  tissues  round  the  gland,  but  the  skin  was  not  adherent.  The 
bowels  were  constipated.  Patient  was  evidently  ill.  On  tlie  evening  of  admission  '20  cubic  centimetres 
of  serum  were  injected  into  the  abdominal  wall.  Next  day  thei-e  was  no  change  in  the  patient's 
condition,  with  the  exception  of  the  fact  that  the  bubo  was,  if  anything,  less  tender,  and,  as  on  the 
18th,  no  further  improvement  had  taken  place,  20  cubic  centimetres  of  the  serum  were  injected  into 
a  vein  of  the  right  arm.  In  the  evening  great  improvement  had  taken  place  in  the  patient's  sense  of 
wellbeing,  and  she  expressed  herself  as  feeling  very  much  better.  The  tongue  was  more  moist,  the 
headache  had  gone,  and  the  pain  in  the  bubo  was  much  less.  From  this  point  convalescence  was  good, 
no  rise  of  temperature  occurring  subsequently. 

*  Case  No.  24. — Mary  M.,  14,  admitted  September  15th.  Patient  on  night  prior  to  admission 
became  gradually  very  ill  with  severe  frontal  headache.  On  daj^  of  admission,  sickness  and  vomiting 
were  the  most  prominent  symptoms,  but  she  also  complained  of  a  tender  swelling  in  her  left  axilla. 
On  admission,  the  temperature  was  99"8,  the  pulse  was  120,  and  the  respirations  were  28.  The  face 
was  of  an  earthy  colour,  with  an  anxious  look  ;  the  lips  were  dry  and  the  skin  was  hot  to  the  touch. 
The  tongue  was  dry  over  the  dorsum,  but  the  edges  were  red  and  moist.  There  was  no  rash.  Four 
inches  from  the  base  of  the  axilla  there  was  a  single  small,  hard,  tender  gland,  which  was  freely 
moveable  ;  at  the  border  of  the  latissimus  dorsi  Ijehind  there  was  another  gland  rather  more 
obvious,  but  not  so  tender.  No  other  complaints  were  made  at  the  time  of  admission.  No  serum 
was  given,  as  the  patient  did  not  appear  particularly  ill.  Next  evening,  the  temperature  had  risen  to 
101  "4.  It  was  then  noticed,  for  the  . first  time,  that  the  patient  had  on  the  back,  about  the  level  of 
the  spine  of  the  eighth  dorsal  vertibra,  a  small  pustule.  This  pustule  showed  certain  distinctive 
features.  It  was  about  a  quarter  of  an  inch  in  diameter,  the  centre  being  depressed  and  covered 
by  a  scab,  while  the  edge  was  raised,  and  formed  of  a  ring  of  minute  pustules.  An  inflammatory 
zone  of  about  2i  inches  surrounded  this  pustule.  Direct  microscopical  examination  of  the  material 
obtained  from  tlie  pustule  showed  the  presence  of  numerous  quite  characteristic  plague  bacilli,  whilst 
in  many  of  the  leucocytes  degenerating  forms  of  the  same  organism  were  apparent.  Cultures  were 
made,  and  a  characteristic  growth  of  the  organism  obtained.  20  cubic  centimetres  of  serum  was 
injected  subcutaneously.  Next  day,  17th  September,  the  temperature  had  fallen  to  normal,  and 
the  patient  was  somewhat  better;  but,  although  the  gland  in  the  axilla  was  a  little  less  tender,  the 
pustule  showed  no  signs  of  diminishing.  In  the  evening  another  area  of  congestion  appeared  on  the 
left  flank.  The  following  morning  the  patient's  temperature  was  102°,  and  she  was  apparently 
considerably  worse.  The  second  area  of  inflamed  skin  had  now  a  j'ellowish  centre,  as  if  of  commencing 
pustulation.  At  mid-day,  20  cubic  centimetres  of  serum  were  injected  into  the  right  median  basilic. 
In  the  evening  the  patient  spontaneously  expressed  herself  very  much  better,  and  her  temperature  was 
normal.  Next  day,  19th  September,  the  patient  felt  very  well.  The  slough  in  the  centre  of  the 
pustule  had  separated,  leaving  a  healthy  granulating  surface,  and  the  second  erythematous  area  in 
the  flank  had  almost  completely  disappeared.  From  this  point  convalescence  was  uninterrupted. 
(Photograph  to  illustrate  site  of  pustule  and  bubo,  Plate  VI.). 

*  Case  No.  25. — Pi.  M.,  set.  12,  admitted  16th  September,  1900. — Patient  became  ill  on  the  evening 
of  14th  September  with  slight  headache.  Next  morning  he  was  much  prostrated,  and  the  headaclje 
had  become  very  severe.  He  also  made  complaint  of  acute  pain  in  the  left  axilla,  and  this  seems 
to  have  been  from  that  time  up  to  his  admission  to  hospital  his  most  clamant  symptom.  No  history 
of  rigor,  sickness,  or  vomiting  could  be  obtained.  On  admission  his  temperature  was  102-4*, 
the  pulse  numbered  130,  and  the  respirations  36.  The  patient  looked  very  ill.  The  face  had  the 
characteristic  ashy  pallor,  with  drawn  brows.  The  lips  were  dry  and  fissured  ;  the  tongue  dry 
and  brown  on  the  dorsum,  but  moist  and  red  at  the  edges.  The  ej'es  .were  clear,  and  the 
conjunctivae  not  injected.  There  was  some  mental  obscuration,  dependent  partly  on  the  grave 
prostration,  but  partly  also  on  his  continual  dread  of  the  pain  consequent  on  his  being  even  carefully 
handled.  The  slightest  movement  caused  the  most  acute  pain,  referred  chiefly  to  the  left  axilla. 
Palpation  in  this  region  revealed  the  presence  of  a  small  indurated  gland,  which  was  very  tender. 
Unlike,  however,  what  had  been  observed  in  other  cases,  the  tenderness  was  not  limited  to  the 
immediate  neighbourhood  of  this  bubi,  but  extended  to  the  outer  portion  of  the  pectoral  region. 

Physical  examination  of  the  lungs  revealed  nothing  noteworthy  beyond  a  few  localised  patches 
of  crepitant  lale.    There  was  no  dyspncea,  and  no  evidence  of  pulmonary  engorgement.    The  heart's 


52 


action  was  very  feeble,  and  the  apex  impulse  widely  diffused.  The  pulse  was  full  and  bounding,  but 
of  very  poor  tension.  The  spleen  was  not  enlarged.  The  urine  contained  no  albumen.  The  bowels  were 
constipated. 

Twenty  cubic  centimetres  of  serum  were  injected  subcutaneously,  and  also  20  cubic  centimetres 
into  the  right  median  cephalic  vein  on  the  evening  of  admission. 

On  17th  September  patient's  general  condition  seemed  rather  better,  the  tongue  being  moister, 
and  ihe  expression  of  the  face  less  anxious.  There  was  also  less  tenderness  in  the  left  axilla.  On  the 
18th  his  condition  was  worse,  and  an  additional  dose  of  20  cubic  centimetres  of  serum  was  injected 
subcutaneously  in  the  afternoon.  On  the  19th,  20  cubic  centimetres  were  injected  intravenously. 
Next  day  there  was  no  apparent  improvement,  tlie  respirations  were  more  frequent,  and  an  increased 
amount  of  crepitant  rale  was  audible  over  both  lungs.  There  was,  however,  no  cough,  and  no 
sputum  could  be  obtained.  At  the  outer  part  of  the  left  pectoral  region  was  an  indefinite  swelling, 
feeling,  on  palpation,  as  if  situated  under  the  pectoral  muscle,  suggestive  of  deep  abscess  formation. 
The  axillary  bubo  was  no  longer  tender.  As  the  temperature  since  admission  seemed  to  indicate 
a  pyogenic  infection,  and  as  the  serum  had  no  effect  on  its  course,  no  more  serum  was  given,  on  the 
assumption  that  the  patient  was  now  suffering  from  the  effects  of  a  double  infection  rather  than 
from  plague  alone.  This  supposition  was  borne  out  by  the  alleviation  of  the  pain,  and  tenderness  at 
the  site  of  the  bubo,  and  the  recent  swelling  under  the  pectoral  muscle.  By  the  2oth  this  swelling 
gave  definite  signs  of  deep  fluctuation,  and  was  incised  after  freezing  the  skin,  giving  exit  to  a 
sero-purulent  fluid,  which,  on  cultivation,  gave  a  pure  culture  of  the  staphylococcus  aureus,  but  no 
B.  pestis  was  isolated.  The  abscess  was  found  to  be  situated  under  the  pectoralis  minor.  From  this 
time  patient's  condition  became  rapidly  worse,  and  he  died  on  September  28th.  The  respiration  was 
very  rapid,  but  patient  was  so  ill  that  he  was  not  disturbed  by  physical  examination. 

Throughout  the  urine  remained  free  from  albumen,  except  on  the  22nd  and  23rd  September, 
when  the  specimens  obtained  showed  a  faint  trace. 

Post-mortem  Examination,  S9th  September,  1900,  by  Professor  Pertik, 

Buda-Pesth. 

External  A ppearances. — The  body  is  that  of  an  ill  nourished  child.  The  bones  are  poorly  developed 
and  there  is  great  emaciation.  The  skin  is  shrivelled  ;  on  the  back  are  numerous  medmm-sized  livid 
yoat-mortem  stains.  In  the  left  mammillary  line  in  the  second  intercostal  space  is  a  drain  opening  of 
about  6  mm.  in  diameter.  A  probe  can  be  easily  introduced  towards  the  axilla  through  this  opening, 
which  traverses  both  the  pectoralis  major  and  minor.  The  opposed  surfaces  of  both  muscles  are 
brawny  and  infiltrated  with  pus.  Under  the  pectoralis  minor  is  a  mass,  5  cm.  long,  10  cm.  broad,  and 
2  cm.  thick,  which  reaches  into  the  left  axilla,  and  consists  of  lymphatic  glands  and  connective  tissue, 
semi-fluid,  and  infiltrated  with  pus.  The  former  (lymph  glands)  are  partly  softened,  and  of  a 
yellowish-grey  colour,  and  partly  of  a  firmer  consistence,  showing  within  smooth,  slightly  granular 
cut  surfaces,  dull  areas  of  coagulation  necrosis.-  The  latter  (connective  tissue)  is  of  the  consistence  of 
thick  cream,  infiltrated  with  pus,  mixed  with  detritus,  fat  globules,  and  puriform  masses.  In  parts  of 
the  muscles — the  pectoralis  minor  and  the  serratus  auticus  major — there  are  purulent  areas  running 
parallel  with  the  muscular  films. 

Position  of  Organs. — The  diaphragm  reaches  on  the  right  side  to  the  inner  border  of  the  fifth,  and 
on  the  left  to  the  upper  border  of  the  sixth  rib.  The  liver  in  the  middle  line  reaches  10  cm.  under  the 
xyphoid  process,  and  in  the  right  mammillary  line  reaches  5  cm.  below  the  costal  margin.  The 
intescines  are  moderately  distended  with  gas.  The  lower  end  of  the  ileum  is  contracted.  In  the 
abdominal  cavity,  in  Douglas'  pouch,  there  is  about  60  cc.  of  clear  wine-red  fluid. 

Exaviination  of  Organs.  —  On  removing  the  sternum  there  escapes  about  30  co.  of  thin  yellow  pus 
from  the  upper  end  of  the  anterior  mediastinum.  This  pus  evidently  comes  from  the  thymus  gland, 
which  has  been  cut  into,  and  evidently  consists  of  an  abscess  with  a  thin  wall.  The  gland  itself  is 
about  7  cm.  long,  and  about  2'8  cm.  in  thickness  at  the  base. 

Lungs. — The  anterior  edges  of  the  lungs  are  considerably  congested,  and  adherent  to  the  chest 
wall,  especially  on  the  right  side.  The  right  lung  is  very  large,  as  in  the  state  of  deep  inspiration. 
On  superficial  examination  there  are  seen  several  sub-pleural  nodules,  free  from  air,  and  of  a  pale 
yellowish-red  colour,  about  the  size  of  hazel  nuts.  These  appear  above  the  level  of  the  crepitant 
depressed  lung  substance.  The  middle  lobe  is  enlarged  and  non-crepitant,  of  liver-like  consistence. 
The  cut  surface  shows  many  areas  of  a  reddish-grey  colour,  tough,  non-crepitant,  and  exuding  fluid. 
After  scraping  with  a  knife  the  surface  appears  finely  granular,  and  allows  the  lobular  structure  of 
the  middle  lobe  to  be  clearly  recognised.  At  the  cut  surface  of  the  upper  and  lower  lobes  the 
hypereemic  lung  tissue,  which  liere  exudes  much  frothy  fluid,  and  is  also  in  parts  atelectatic,  appears 
depressed,  and  within  that  tissue  are  prominent  areas  about  the  size  of  a  hazel  nut,  which  show  the 
characteristics  of  disseminated  lobular  pneumonia.  In  the  lower  lobe  some  of  these  areas  reach  the 
size  of  a  walnut.  In  the  left  lung  are  about  twenty  similar  nodules  of  lobular  infiltration,  which  in 
the  lower  lobe,  and  more  especially  at  the  hinder  and  lower  edge,  are  wedge  shaped.  The  bronchial 
glands  are  greatly  enlarged  ;  they  are  pale,  and  at  the  cut  surfaces  show  a  few  opaque  spots. 

The  thyroid  gland  is  small,  and  of  a  pale  reddish -brown  colour,  with  a  finelj'  granular  surface. 

The  larynx  and  trachea  have  the  mucous  membrane  congested,  and  covered  with  a  reddish-yellow 
frothy  secretion. 

The  Heart. — In  the  pericardium  are  about  20  cc.  of  a  finely  flocculent  clear  serum.  The  right 
heart  is  in  complete  diastole,  the  left  in  moderate  sj^stole.  The  apex  of  the  heart  is  formed  by  the 
left  ventricle— the  size  about  that  of  a  child's  tist.  In  the  heart  there  is  soft  dark-red  clot  and  fluid 
blood.    The  myocardium  is  very  friable  and  opaque  looking,  "cloudy  swelling."    The  substance- 


53 


is  pale  yellowish-brown  in  colour.  These  characters  are  especially  well  marked  in  the  papillary 
muscles.    The  valves  are  patent. 

The  spleen  is  enlarged  8  cm.  long,  3'5  broad,  and  2-5  thick.  The  capsule  is  thin  and  stretched. 
The  cut  surface  is  smooth.  The  pulp  is  not  easily  removed  from  the  stroma.  The  malpighian  bouiea 
are  enlarged  and  hyperffimic,  of  a  dark-brown  colour,  perhaps  also  hajmorrhagic. 

The  suprarenals  are  of  medium  size  ;  the  substance  is  somewhat  injected. 

The  kidneys  are  of  medium  size.  The  cortical  substance  is  friable,  opaque,  and  without  obvious" 
fatty  change.  The  cut  surface  projects  a  little  beyond  the  medulla.  It  is  of  a  pale  reddish-yellow 
colour.  The  medulla  is  congested,  and  its  cut  surface  is  slightlj^  depressed.  Tlie  bladder  is  distended 
and  filled  with  flocculent  yellow  urine. 

Tlie  stomach. — The  mvicous  membrane  is  injected.  In  the  neighbourhood  of  the  pylorus  are  a 
few  small  punctiform  hEemorrhages. 

The  liver  is  of  medium  size.  The  capsule  is  thin  and  stretched  and  smooth.  The  tissue  generally 
is  friable,  and  is  in  a  state  of  "  cloudy  swelling."    Its  colour  is  a  pale  yellowish-brown. 

The  inteuiiien  have  mucous  contents.  At  the  lower  end  of  the  ileum  ai'e  three  circumscribed 
Injected  areas.    The  solitary  follicles  and  mesenteric  glands  ai-e  not  enlarged. 

The  inguinal  glands  on  both  sides,  and  the  right  axillary  glands,  are  about  the  size  of  beans,  of  a 
greyish-yellow  colour,  with  a  smooth  cut  surface  and  ordinary  consistence. 

Diagnosis. — Purulent,  left-sided,  sub-clavicular,  and  axillary  bubo.  Polyadenitis.  Abscess  in  the 
thymus  gland.  Lobular  pneumonia  of  both  lungs,  here  and  there  necrotic.  Hyperplasia  of  the  spleen. 
Parenchymatous  degeneration  of  the  myocardium,  liver,  and  kidneys.  (Bubonic  Plague  with  secondary 
lobular  pneumonia.)  Proximate  cause  of  death — parenchymatous  degeneration  of  the  heart  muscle, 
and  resulting  cardiac  failure,  with  hypersemia  and  oedema  of  the  lungs. 

*Case  No.  26. — Mrs.  G. ,  age  24,  admitted  19th  September.  Patient  became  ill  on  the  day  prior 
to  admission.  The  initial  symptoms  were  not  of  great  severity,  slight  headache  and  a 
feeling  of  general  malaise  only  being  complained  of.  Coincident  with  these  symptoms  a  tender 
swelling  was  discovered  by  patient  herself  in  the  right  groin.  It  is  to  be  noted,  however, 
as  accounting,  perhaps,  for  the  comparative  mildness  of  the  onset,  that  seven  days  prior  to 
the  commencement  of  illness  she  had  received  a  prophylactic  injection  of  10  c.c.  of  Yersin's  curative 
serum.  -On  admission  patient  did  not  look  as  if  she  were  very  ill.  Frontal  headache  of  moderate 
severity  was  complained  of,  and  in  the  right  groin,  involving  the  vertical  chain  of  glands,  the  above- 
mentioned  swelling,  which  was  about  the  size  of  a  walnut,  was  observed.  The  glands  were  more  or 
less  adherent  to  one  another,  and  also  to  the  subjacent  tissues,  but  the  overlying  skin  was  freely 
moveable  and  not  inflamed.  The  tongue  was  moist  and  clean  ;  the  bowels  were  constipated.  The 
illness  had  interrupted  the  suckling  of  a  three-months'-old  child,  and  on  this  account  the  breasts  were 
enlarged  and  tender.  The  course  of  the  illness,  however,  was  short,  lasting  in  all  about  five  days,  and 
the  only  clamant  symptom  complained  of  was  the  frontal  headache.  The  fever  was  maintained  at  a 
high  level  for  two  or  three  days,  ranging  between  100°  F.  and  104°  F.,  but  other  symptoms  were  not 
present  in  like  severity.  The  pyrexia  might  be  regarded  as  due  to  three  factors — 1st,  the  attack  of 
plague,  probably  the  most  important ;  2nd,  the  condition  of  the  breasts,  which  became  very  large  and 
tender  ;  3rd,  serum  fever.  The  maximum  temperature  occurred  on  the  ninth  and  tenth  days  after  the 
prophylatic  injection  of  serum — i.e.,  at  the  period  when  the  pyrexia  due  to  serum  usually  made  its 
appearance.  On  October  4th  spontaneous  rupture  of  the  bubo  took  place,  and  from  the  discharges 
obtained  on  that  day  virulent  plague  bacilli  were  recovered.  From  this  point  onwards  convalescence 
was  rapid  and  complete. 

*  Case  No.  27. — Mary  G.,  set.  6,  admitted  September  19th.  This,patient,  who  is  the  daughter  of 
Mrs.  G.,  and  niece  of  Charles  M'M.  (Cases  No.  17  and  No.  13),  became  ill  on  the  day  prior  to 
admission  with  severe  prostration  and  headace. 

On  admission  patient's  temperature  was  101  -2°  F.,  the  pulse  was  146,  and  the  respirations  were  44. 
The  aspect  was  that  of  a  person  acutely  ill.  The  face  was  pale  and  somewhat  cyanotic,  the  lips  dry  and 
bine.  The  tongue  was  dry  over  the  dorsum,  but  the  edges  were  moist  and  clean.  The  child  lay  in  a 
semi-comatose  state,  and  did  not  even  recognise  her  mother,  who  lay  in  the  next  bed.  The  right 
inguinal  region  was  the  seat  of  a  swelling  about  the  size  of  a  hen's  egg,  and  on  examination  this  was 
seen  to  consist  of  a  mass  of  enlarged  and  tender  lymphatic  glands.  There  was  also  some  peri- 
glandular infiltration,  but  no  reddening  of  the  skin.  Examination  of  the  lungs  failed  to  detect 
anything  notewortliy. 

On  the  evening  of  admission  intra-venous  injection  of  the  curative  serum  was  attempted,  but 
without  success,  as  the  veins  were  very  thin-walled  and  deeply  embedded  in  a  thick  layer  of  adipose 
tissue.    20  c.c.  of  serum  were  therefore  given  subcutaneously  into  the  wall  of  the  abdomen. 

Next  evening  the  child  was  rather  worse,  the  temperature  somewhat  higher,  and  the  pulse  softer 
and  more  compressible.  A  second  attempt  to  inject  serum  into  a  vein  failed,  and  accordingly  40  c.c. 
of  serum  were  again  injected  into  the  wall  of  tiie  abdomen.  The  following  morning  the  patient's 
condition  was,  if  anything,  shghtly  better,  though  she  was  still  more  or  less  unconscious.  The  pulse, 
however,  was  firmer,  and  the  respirations  somewhat  slower.  A  third  attempt  at  intra-venous 
injection  having  failed,  40  c.c.  of  serum  were  injected  for  the  third  time  nito  the  abdominal  wall. 
In  the  evening  a  very  marked  improvement  was  observed,  the  child  having  regained  its  natural 
colour,  and  being  now  quite  conscious  for  the  first  time.  She  smilingly  recognised  her  mother.  The 
improvement,  however,  was  not  maintained  beyond  the  following  morning.     On  the  evening  of  the 


54 


22nd  the  temperature  again  rose,  and  the  pulse  became  very  feeble.  From  this  point  onwards  patient 
sank  steadily.  Death  was  associated  with  marked  hj'postatio  congestion  of  the  lungs,  and  was  directly 
due  to  heart  failure.  No  additional  serum  was  given  on  account  perhaps  of  undue  timidity,  for,  as  bj' 
this  time,  moderately  severe  constitutional  disturbance  following  on  small  doses  of  the  serum  had 
been  frequently  observed  in  healthy  persons,  it  was  not  deemed  advisable  to  persevere  with  the 
treatment. 

Case  No.  28. — Baby  M.,  born  in  Hospital,  16th  September,  at  4.30  a.m. — Though  the  mother  had 
a  blood  infection  of  B.  pestis  (v.s.),  the  placenta  showed  no  macroscopic  lesion.  At  birth  the 
child  was  completely  asphyxiated,  and  no  spontaneous  attempt  at  respiration  was  made  for  almost 
three-quarters  of  an  hour. 

For  eight  days  the  child  seemed  to  be  quite  well,  but  on  the  ninth  day  it  was  observed  that  the 
neck  seemed  rigid,  and  on  examination  some  induration  was  discovered  on  the  left  side  of  the  neck, 
high  up,  at  the  posterior  border  of  the  sterno  mastoid.  Next  day  a  few  isolated  glands  could  be  felt, 
about  the  size  of  a  pea,  in  the  above-mentioned  situation,  and  the  group  of  glands  lying  in  the  anterior 
triangle  of  the  neck  were  by  this  time  also  affected.  On  the  right  side  there  were  also  some  enlarged 
lymphatic  glands,  but  not  so  large  as  those  on  the  left  side.  The  temperature,  which  had  previously 
not  risen  above  99 '6°,  rose  on  this  evening  to  101°.  Next  day  the  child  refused  its  food,  and  vomited 
frequently.    The  child  rapidly  sank,  and  died  on  the  following  afternoon. 

Post-mortem  Examination,  27th  September,  1900,  by  Br.  R.  M.  Buchanan. 

External  Appearances. — The  body  is  that  of  a  well-formed  infant  of  recent  birth.  There  is 
lividity  of  the  whole  surface.  The  circumference  of  the  neck  is  greatly  increased  by  an  ill  defined 
elongated  swelling  along  the  line  of  the  hinder  border  of  the  sterno-mastoid  muscle  on  each  side,  and 
diffuse  swelling  of  the  front  and  back  of  the  neck. 

Chest.  — The  heart  shows  very  marked  parenchymatous  degeneration,  the  muscle  having  a  pale, 
granular,  parboiled  appearance.    Its  cavities  are  all  occupied  by  soft  very  dark  coloured  blood  clots. 

The  pleural  cavities  contain  opaque  yellow  fluid.  The  pleural  surface  of  both  lungs,  in  the  lateral 
aspect,  shows  a  thin  film  of  fibrinous  exudation. 

The  ler't  luri'j  appears  intensely  hyperfemic  and  partly  consolidated.  It  floats  in  water.  The 
pleural  surface  presents  a  considerable  number  of  minute  hiemorrhagic  points,  several  of  which  have 
a  yellowish  centre.  On  section  similar  hsemorrhagic  areas  are  disposed  throughout  the  substance  of 
both  lobes  in  the  manner  of  a  broncho-pneumonia. 

The  right  lung  is  rather  more  consolidated  and  more  hypereemic  than  the  left,  and  the  pleural 
surface  shows  a  larger  number  of  minute  yellow  points  with  a  marginal  zone  of  intense  congestion  or 
haemorrhage.  In  the  lung  substance  hsemorrhagic  lobular  consolidations  are  also  more  numerous  and 
more  extensive. 

Ah  iomeii.—'T'he  spleen  is  much  enlarged  alid  of  a  firm  consistence,  resembling  that  of  the  liver. 
Section  of  the  organ  displays  intense  hypertEmia,  the  cut  surfaces  being  very  dark  in  colour,  and 
having  a  homogeneous,  glossy  appearance. 

The  liver  is  enlarged  and  extremely  hypersemic,  very  dark  blood  flowing  freely  from  the  vessels  on 
incision.  Its  substance  shows  very  marked  cloudy  swelling,  and  parts  of  the  cut  surface  are  very 
pale.  A  small  number  of  minute  yellowish  foci,  from  1  to  2  mm.  in  diameter,  are  distributed 
throughout  the  organ.  Those  at  the  surface  are  not  raised,  and  they  are  all  of  firm  consistence.  The 
capsule  of  Glisson  is  oedematous. 

The  kidneys  are  hypersemic,  and  the  cut  surfaces  are  studded  with  minute  hoemorrhagic  foci, 
disposed  chiefly  in  the  pyramids.  The  cortical  tissue  is  dull,  opaque,  and  of  a  brownish-yellow 
colour. 

The  right  fupra-i-enal  gland  is  considerably  swollen,  and  median  section  displays  the  whole 
organ  transformed  into  a  dense  yellow  cheesy  looking  mass  by  coagulation  necrosis.  The  left  sut  ra- 
reiial  gland  is  very  hypersemic.    Its  medullary  tissue  is  notably  oedematous,  the  fluid  being  sanious. 

Glands. — There  is  a  general  enlargement,  with  hyperemia  of  the  lymphatic  glands.  The 
mesenteric,  inguinal,  prevertebral  and  bronchial  glands  are  all  hypersemic  and  increased  in  size,  while 
the  axillary  and  cervical  glands  have  undergone  great  enlargement. 

The  axillary  glands  are  in  the  form  of  a  flattened  mass  rather  larger  than  an  almond,  with  cedema 
and  hypersemia  of  surrounding  tissues.  On  section  these  glands  appear  intensely  congested,  but 
no  lijemorrhage  or  necrosis  is  detected. 

On  dissecting  the  tissues  of  the  neck  to  expose  cervical  glands  a  hsemorrhagic  oederqa  of  the 
subcutaneous  tissue  is  displayed.  The  glands  behind  the  sterno-mastoid  muscles  form  a  dense 
elongated  mass  on  both  sides.  The  glands  comprising  each  mass  are  seen  on  section  (Fig.  2)  to  have 
attained  a  size  varjdng  from  an  eighth  to  half-an-inch  in  diameter.  All  are  intensely  engorged  and 
some  are  necrosed.  The  latter  are  opaque,  finely  granular,  and  greyish,  or  finely  mottled, 
brownish-red,  and  grey. 

A  similar  mass  of  enlarged  glands  is  found  on  each  side  of  the  larynx  and  trachea,  most  of  the 
glands  in  which  present  this  hremorrhagic  granular  opaque  appearance  of  necrosis. 

The  occipital  tissues  are  oedematous,  and  the  occipital  glands  partake  in  the  general  enlargement, 
without  necrosis. 

The  Thymus  gland,  the  larynx,  and  the  trachea  are  hypersemic. 

The  stomach  presents  a  few  small  slightly  hypersemic  patches.    The  intestines  are  normal. 


Case  D. — Mrs.  G.,  aet.  55,  admitted  September  1st. — Patient  was  ^mitted  in  a  comatose 
condition  from  which  she  could  not  be  roused.  No  definite  liistory  could  be  obtained,  but  the 
illness  probably  dated  from  August  21.  On  admission  the  temperature  was  102''2,  the  pulse  104,  and 
the  respiration  36.  The  tongue  was  dry  and  browu  and  the  gums  covered  with  scales.  The 
expression  was  that  of  stupor.  The  eyes  were  injected  and  the  pupils  contracted.  The  skin  was 
covered  with  a  mottling  resembling  that  of  typhus.  The  heart's  sounds  were  very  weak  and  the 
lungs  showed  signs  of  marked  hypostatic  congestion.  lu  the  left  groin,  above  Poupart's  ligament, 
was  a  sausage-shaped  swelling,  evidently  consisting  of  enlarged  lymphatic  glands,  not,  however, 
tender.    She  remained  comatose,  sank  gradually,  and  died  on  September  4th. 

Post-mortem  Examinat  ion,  4th  Se2)tember,  1900,  by  Br.  R.  M.  Buchanan. 

External  appearance^. — The  skin  generally  is  dusky,  and  the  surface  of  the  abdomen  is  marked 
by  a  faint  typhus-like  mottling  ;  numerous  petechire  are  visible  over  the  abdomen  and  thighs. 

Ciiefit. — The  heart  is  soft  and  flabby,  the  muscular  tissue  appearing  pale  brown  on  section.  The 
cusps  of  the  aortic  and  pulmonary  valves  are  slightly  thickened  and  fenestrated. 

The  riijht  lung  is  firmly  adherent  all  over.  It  is  hypersemic  and  oedematous  posteriorly,  and  the 
lower  lobe  shows  some  condensation  in  indefinite  areas. 

The  left  lung  is  hyperffimic  and  oedematous. 

Abdomen. — The  spleen  is  soft  and  diffluent.  The  livr  shows  some  cloudy  swelling.  The  kidneys 
are  also  marked  by  cloudy  swelling,  and  present  a  granular  surface  on  removal  of  the  capsule. 

Glands. — The  glands  in  the  left  groin  are  much  enlarged,  and  surrounded  by  oedematous  tissue. 
The  glands  involved  in  the  enlargement  lie  along  Poupart's  ligament.  On  section  they  all  have  the 
appearance  of  well-defiued  abscesses,  containing  shreds  of  necrosed  tissue  and  brownish  viscid  pus,  and 
delimited  by  a  thin  rind  of  residual  gland  tissue  infiltrated  with  blood.  They  have  all  attained  a 
a  fairly  uniform  diameter  of  about  three  quarters  of  an  inch. 

The  same  set  of  glands  in  the  right  inguinal  region  is  also  enlarged,  but  to  a  lesser  fextent.  The 
largest  of  the  group  being  less  than  half-an-inch  in  diameter,  and  being  the  only  one  which  displays 
suppuration. 

The  prevertthral  glands,  especially  on  the  left  side,  are  hyperiemic  and  slightly  swollen. 
The  glands  in  the  other  parts  appear  normal. 


Clinical  History  of  a  Pneumoma  (?  Plague). 

*  Case  X.— A.  A.,  set.  18,  admitted  6th  September,  1900. — Patient  was  apparently  in  full 
liealth  on  the  morning  of  1st  September,  but  during  the  course  of  the  evening  he  complained 
of  slight  headache.     From  this  point  onwards  he  evidently  felt  somewhat  out  of  sorts,  but 
was  able  to  continue  at  work  till  4th  September,  and  was  even  present  at  a  dance  the  same 
evening.    Early  on  the  morning  of  the  5th,  however,  he  became  acutely  ill  with  pain  in  the 
right  side.    The  symptoms  of  illness  appeared  to  have  developed  with  great  rapidity,  and  on  the 
evening  of  the  6th  he  was  admitted  to  the  Western  Infirmary.    His  appearance  there  being  regarded 
with  suspicion,  the  physician  in  charge  deemed  it  advisai)le  to  have  him  transferred  to  P)elvidere  the 
same  evening.    On  admission  patient  was  evidently  acutely  ill.    The  admission  temperature  was 
99  8  F.,  but  this  was  evidently  due  to  collapse,  as  the  record  prior  to  removal  from  the  Western 
Infirmary  was  104  F. ).     The  pulse  numbered  124  per  minute  and  was  soft  and  full.    The  respirations 
were  42,  but  there  was  no  evidence  of  any  respiratory  distress.    The  face  generally  was  of  an  ashy- 
grey  colour,  with  a  dusky  flush  in  the  malar  regions.    The  eyes  were  held  widely  open,  the  conjunc- 
tivee  injected,  and  the  pupils  dilated.    The  tongue  was  moist  and  covered  with  a  white  fur.  The 
skin  showed,  especially  on  the  trunk,  a  general  erythematous  mottling,  resembling  that  already  noted 
in  plague.    This  was  also  preseut  on  the  extensor  surfaces  of  the  forearms,  though  to  a  less  extent. 
Examination  of  the  lymphatic  glandular  system  revealed  slight  enlargement  of  the  glands  in  the  right 
axilla  and  also  of  those  in  the  left  groin.    No  special  tenderness,  however,  was  complained  of  on 
manipulation.    Physical  examination  of  the  lungs  revealed  slight  relative  dulness  to  percussion  over 
the  left  back  from  the  spine  of  the  scapula  downwards.     The  breath  sounds  over  this  area  were 
distinctly  tubular,  and  the  vocal  resonance  and  vocal  fi'emitus  were  both  exaggerated.    Next  day 
patient's  condition  was  much  the  same,  the  evening  temperature  being  105  F.    He  was  drowsy,  how- 
ever, and  had  some  sligiit  muttering  delirium,  but  made  no  complaint  of  pain.    The  expectoration, 
which  was  very  scanty  and  viscous,  was  slightly  tinged  with  blood.     On  direct  microscopical 
examination  of  the  sputum,  large  numbers  of  diplococci  were  seen,  and  there  was  also  present  in  very 
considerable  numbers  a  bi-polar  stainiug  bacillus,  which  was  decolourised  by  Gram's  method,  and 
morphologically  was  indistinguishable  from  that  of  plague.    In  many  parts  of  the  slide  this  bacillus 
appeared  to  be  present  in  almost  pure  culture. 

Examination  of  the  chest  on  8th  September  showed,  in  addition  to  the  signs  already  enumerated, 
a  certain  amount  of  fine  subcrepitant  rale  accompanying  the  inspiratory  murmhr  in  the  consolidattd 
area.  Over  the  lower  lobe  of  the  right  lung  also  a  variable  amount  of  rather  fine  bronchial  rale  was 
heard.  The  upper  part  of  both  lungs  yielded  a  perfectly  clear  percussion  note  whilst  the  respiratory 
murmur  in  this  situation  was  entirely  devoid  of  rale.  The  temperature  did  not  reach  normal  till  12th 
September,  and  terminated,  not  by  a  true  crisis,  but  by  a  somewhat  rapid  lysis  extending  over  48 
hours.  This  lysis  resembled  the  lysis  of  plague  rather  than  that  of  pneumonia,  and  was  unaccompanied 
by  sweating,  the  skin  remaiuing  dry  to  the  touch.    Convaleaceuce  was  rapid  and  uninterrupted. 


56 


Unfortunately  the  sputum  was  not  inoculated  directly  into  an  animal,  and  on  account  of  an 
accident  to  the  regulator  of  the  incubator,  the  only  culture  of  the  above-mentioned  plague-resembling 
bacillus  was  destroyed  at  a  time  when  it  was  no  longer  possible  to  obtain  another.  The  definite 
diagnosis  of  this  case  therefore  remained  to  a  certain  extent  doubtful.  During  convalescence,  how- 
ever, a  very  pronounced  agglutinative  reaction  was  obtained  from  the  blood  in  a  dilution  of  1-25. 

It  may  here  be  remarked  that,  as  making  for  the  diagnosis  of  plague  pneumonia,  the  serum  of  this 
patient  taken  during  late  convalescence  exhibited  decided  prophylactic  qualities.  This  was 
demonstrated  by  the  following  experiment  performed  by  Dr.  Cairns.  Two  white  mice,  A  and  B,  of 
approximately  equal  weight,  were  each  inoculated  with  a  lethal  dose  of  an  active  and  virulent  culture 
of  plague  bacilli.  In  the  case  of  B,  however,  |  c.c.  of  blood  serum,  taken  from  the  patient  during  the 
ninth  week  of  illness  was  injected  into  the  subcutaneous  tissues  of  the  back  twenty-four  hours  before 
performing  the  inoculation.  The  following  results  were  observed  : — Control  animal  A  became  obviously 
very  ill  12  hours  after  inoculation,  and  died  at  the  end  of  twenty -four  hours.  Post-mortem  examination 
showed  the  spleen  to  be  slightly  enlarged  and  engorged  with  free  plague  bacilli,  none  of  which  were 
enclosed  by  the  splenic  cells.  The  organisms  were  also  present  in  the  blood  in  very  large  numbers. 
Animal  B  never  appeared  to  be  particularly  ill  at  any  time,  but  died  suddenly  on  the  twelfth  day 
after  injection.  Post-mortem  examination  showed  the  spleen  to  be  slightly  enlarged,  and  on 
examining  smear  preparations  of  splenic  juice  only  a  few  free  bacilli  could  be  found  after  a  prolonged 
search.    The  splenic  cells,  however,  contained  plague  bacilli  in  all  stages  of  digestion. 


CHARTS,  SHOWING  TEMPER ATU RE ,  WITH  PULSE  AND  RESPIRATION  RATES, 
OF  THE  MORE  INTERESTING  CASES  (with  references). 


August  JilQO  Septcmi/er 


August  WOO 


Seplemier 


Aagust,  /SOO  Scptcinie/' 


August.  /ffCO 


Sept 


DATE. 

■25 

27 

28 

23 

3/ 

/ 

DAY  OF 
ILLNESS. 

6 
M  E 

7 
M  £ 

6 
M  E 

5 
M  E 

10 
M  E 

M  E 

/2 

M  £ 

IZ 
M  E 

M  E 

.07- 
no  106° 
lOO  105° 

in  so  w 

E 

S    60  103° 
?     7  0  102° 
H      60  101° 
gJ      50  100° 
P  99° 
98° 

'-o"  97° 

— 1 — 1 

— I— 

\- 

V 

^ 

V 

— t— 

\ 

AuffUsl:l9C'0  Septemder 


23 

30 

31 

/ 

3 

•it 

 1 

1 

2. 
M  E. 

3 
M  E 

M  E 

J5" 
M  E 

6 
M  E 

7 
M  E 

a 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

1 

— t— 

J 

1 

/ 

»- 

— i — 

i 

i 

1 

-i- 

■J— 

\ 

A 

A 

-4- 

H- 

-t- 

A 

V 

A 

vf 

— 

-f- 

— 1  

1 

i 

DAY  OF 
ILLNESS. 


CASE 

N9I4- 

A.D. 

M.AETie 


107* 
80  106° 
7  0  105' 

60  \W 

SO  103° 
IOi° 
101° 
.100° 
99° 
98° 

Resp 

ic,  97° 


SepfemZer/SOO 


DATE. 

/5 

/6 

/7 

/<9 

20 

£2 

DAY  OF 
ILLNESS. 

M  £ 

5 
M  E 

.it 
M  E 

5 
M  E 

6 
M  E 

7 
M  E 

a 

M  E 

M  E 

/O 
M  E. 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

'\Qa'  107° 
90  106° 
80  105° 

H 

2    70  104° 

K 

1  103° 
z; 

£  102° 
g  101° 

1 

100° 

s 

P  99° 
'  98° 

Resp 
so  97° 

1 

f 

r 

y 

^ 

i 

I 

4 

- 

— i- 

^ 

1  . 

2- 

A 

a= 

1 

CASE. 
A  ET.  20. 


DATE. 

/5 

le 

DAY  OF 
ILLNESS. 

Z 
M  E 

'5 
M  E 

M  E 

M  E 

M  e!m  6 

M  E 

P'JLSE. 

lao  107° 
170  106° 

160  105° 
3    150  I0t° 
^    K-0  103° 
?  102' 

uJ 

=  ioi» 

s 

98° 

50  97° 

September  /SCO    ScptemZie^  /SOO 


DAY  OF 
ILLNESS. 

'\ta  107° 

130  106° 

120  105° 

no  10+° 

roo  ICS" 

90  102° 

60  101° 


70  100' 
.^0  99' 
98' 

JO  97' 


6 

7 

a 

3 

/O 

// 

/£ 

/3 

/* 

1 

Z 
M  E 

3 
M  E 

M  E 

5 
M  E 

6 
M  E 

7 
M  E 

e 

M  E 

9 
M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

M  E 

1 

— 1— 

p-i- 

I 

— i— 

j 

-j- 

1 

— 1 — 

1 

-i- 

— j— 

— 1 — 

\i 

1 

-f- 
I 

4- 

-i- 

1 

— 1 — 

\ 

-f- 

-f- 

4- 

1 

-A 

1 

1 

j 

i 

September /SCO 


DAY  OF 
ILLNESS 


57 


CLINICAL  BACTERIOLOGY. 

By  J.  Campbell  M'Cluee,  M.B.(Glas.), 
Senior  Res.  Assist.  Physician,  Belvidere  Hospital. 

In  almost  all  the  cases  admitted  to  Belvidere  a  bacteriological  examination 
of  the  bubo  was  attempted  on  admission,  with  varying  result,  according  to  the  length 
of  time  the  patient  had  been  suffering  from  plague  and  the  situation  of  the  bubo, 
it  being  sometimes  impossible  in  the  mild  cases  to  puncture  a  small  deeply- 
situated  gland. 

The  method  of  examination  was  as  follows :— The  skin  over  the  bubo  was 
rendered  sterile;  the  bubo  was  punctured  with  a  sterilised  hy]Dodermic  needle, 
some  fluid  drawn  off  by  the  syringe,  and  cover-glass  preparations  and  inoculations 
on  agar  and  glycerine-agar  made  from  the  contents. 

In  all  cases  of  true  plague,  where  the  bubo  was  examined  during  the  first 
week  of  illness,  the  B.  pestis  was  easily  recovered.  Direct  microscopical  examina- 
tion of  the  fluid  withdrawn  usually  showed  the  characteristic  bi-polar  staining 
bacillus,  but  often  only  in  very  small  numbers,  even  in  the  most  malignant  cases. 
With  one  exception  (case  of  P.M.,  No.  7)  the  cultures  made  on  agar  from  the  same 
fluid  yielded  on  incubation  pure  cultures  of  the  B.  pestis.  In  the  exception  referred 
to  a  large  diplococcus  was  also  present  in  considerable  numbers.  The  bacteriological 
examination  of  the  bubo  was  usually  negative  at  the  end  of  the  second  week ;  in  some 
of  the  milder  cases,  indeed,  the  bacillus  had  disappeared  by  the  seventh  day;  but  in  two 
cases  (P.F.  and  J.  B.,  Nos.  3  and  1)  the  B.  pestis  was  recovered  from  the  bubo  eighteen 
days  after  the  commencement  of  the  illness.  This  was  the  latest  date  in  the 
illness  at  which  the  bacillus  was  recovered  from  the  bubo.  While  cultures  made  from 
the  bubo  after  the  second  week,  as  mentioned  above,  were  almost  invariably  sterile 
direct  microscopical  examination  showed  with  great  constancy  for  some  days  after 
it  was  impossible  to  cultivate  the  bacillus  the  presence  of  certain  degenerate 
bacillary  forms,  such  as  our  experience  had  taught  us  to  associate  with  degenerating 
plague  bacilli.  These  degenerate  forms  were  found  both  free  in  the  fluid,  and  also 
contained  in  cells. 

In  only  one  instance  was  the  bacillus  recovered  from  an  external  lesion,  and 
on  that  occasion  (case  of  M.M.,  No.  24)  it  was  easily  recovered  from  a  small  pustule 
in  the  back.    This  appears  to  have  been  the  original  point  of  inoculation. 

After  the  spontaneous  rupture  of  a  bubo  the  chances  of  recovering  the  bacillus 
are  apparently  very  remote  ;  in  only  one  case  (Mrs.  G.,  No.  26)  was  the  examination 
positive.  Here  typical  forms  of  the  B.  pestis  were  seen  on  direct  microscopical 
examination,  and  proved  to  be  actively  virulent  when  inoculated  directly  into 
animals. 

In  several  instances  inflammatory  conditions  occurred  during  convalescence, 
which,  from  analogy  with  other  infectious  fevers,  might  reasonably  have  been 
supposed  to  be  due  to  metastatic  infection  by  the  B.  pestis,  but  repeated  examina- 
tion failed  to  reveal  the  presence  of  the  specific  organism.  Of  these  instances  may 
be  mentioned  the  case  of  Mrs.  T.  (No.  2),  who  developed  an  acute  otitis  media,  and 
that  of  P.F.,  who  developed  an  acute  conjunctivitis.  In  the  former  of  these  cases 
only  the  B.  pyocyaneus  and  a  diplococcus  were  found  in  the  aural  discharge,  and  in 
the  latter  the  conjunctival  sac  yielded  only  the  staphylococcus  pyogenes  aureus  and 
albus,  a  large  diplococcus,  and  the  so-called  pseudo-diphtheria  bacillus  of  the  eye. 

On  account  of  the  importance,  from  a  public  health  point  of  view,  of  the 
investigation  of  possible  sources  of  infection,  the  urine  was  systematically  examined, 
both  during  the  acute  stages  of  the  disease  and  also  during  convalescence,  although 
much  more  thoroughly  in  the  latter.  In  no  instance  was  the  B.  pestis  recovered, 
the  urine  even  of  R.M.  (No.  25),  an  example  of  the  septicfemic  tyjie  of  the 
disease,  from  whom  characteristic  organisms  were  found  widespread  after  death, 
proving  sterile,  both  by  culture  and  by  the  direct  inoculation  into  mice  and  guinea- 
pigs  of  the  sediment  obtained  by  centrifugalisation. 


58 


In  one  case  post-mortem  examination  showed  that  although  the  B.  pestis  had 
apparently  disappeared  from  the  bubo,  it  still  maintained  its  existence  in  the  body 
in  a  virulent  condition.  In  this  case  (J.B.  No.  1)  the  bacillus  was  recovered  after 
death  from  the  spleen  and  liver,  although  the  date  of  death  was  in  both  cases 
some  six  weeks  after  the  onset  of  the  illness,  and  although  the  bubo  yielded  no 
culture-growths  of  the  specific  organism. 

The  preceding  remarks  apply  to  all  cases  of  plague  observed  here  without 
distinction,  but  some  special  remarks  fall  to  be  made  with  regard  to  double 
infections  and  the  fatal  cases. 

The  result  of  bacteriological  examination  in  the  latter  group  of  cases  is  given 
in  the  accompanying  table. 

The  cases  where  double  infection  was  observed  fall  naturally  into  two  classes — 
(1)  where  the  double  infection  seemed  to  be  primary,  ■i.e.,  where  there  was  no  visible 
external  lesion ;  and  (2)  where  a  pyogenic  infection  seemed  to  follow  the  rupture  of 
a  bubo. 

Glass  I. — All  the  cases  in  this  class  were  fatal — 

(a)  "  P.M."  (No.  7). — This  patient  died  of  the  septicsemic  variety  of  plague.  The  only  organism 
present  beside  the  B.  pestis  was  a  diplococcus  discovered  in  the  bubo. 

(b)  "G.  H."  (No.  18). — This  patient  lived  only  a  few  hours  after  coming  to  hospital,  and  in  all 
his  organs  after  death  were  found  both  the  B.  pestis  and  the  streptococcus  pyogenes,  the  latter  far 
exceeding  the  former  in  numbers.    A  diplococcus  was  also  present  in  the  bubo. 

(c)  "  R.  M."(No.  25). — This  patient's  bubo  was  not  examined  on  admission,  as  he  was  very  ill,  and 
there  was  no  doubt  of  the  diagnosis  either  clinically  or  from  association.  On  the  ninth  day  of  illness, 
as  it  was  evident  that  an  abscess  had  formed  in  connection  with  the  axillary  bubo,  incision  was  made 
and  agar  tubes  inoculated  from  the  pus.  The  cultures  yielded  only  colonies  of  the  staphylococcus 
pyogenes  aureus.  Cultures  made  from  the  blood  during  life  were  invariably  sterile.  On  post-viortem 
examination,  however,  the  B.  pestis  and  the  staphylococcus  pyogenes  aureus  were  recovered  not 
only  from  the  bubo,  but  also  from  the  heart's  blood  and  the  principal  viscera.  The  urine  and 
peritoneal  fluid  were  sterile. 

(d)  "  Mrs.  M."  (No.  22).  —  lu  this  patient  puncture  of  the  bubo  and  examination  of  the  blood  during 
life,  and  cultures  m&d.p,  post  mortem  from  bubo,  heart's  blood,  spleen,  lungs,  liver,  and  retro- peritoneal 
glands,  showed  the  presence  of  B.  pestis,  contaminated  only  by  B.  coli  communis  in  the  abdominal 
organs  and  by  diplococci  in  the  lungs.  The  presence  of  a  diplococcus  in  the  retro -peritoneal  glands 
was,  however,  demonstrated  in  section  after  staining  by  Gram's  method.  This  patient  must,  there- 
fore, be  included  in  the  group  of  primary  double  infections  in  plague. 

Class  II. — To  this  class  belong  four  cases,  in  all  of  which  secondary  infection 
seemed  to  be  associated  with  sloughing  of  the  buboes,  as  the  latter  all  gave  only 
pure  cultures  of  the  B.  pestis  prior  to  the  beginning  of  necrosis. 

(a)  "  Mrs.  T."  (No.  2). — After  rupture  of  the  bubo  the  staphylococcus  pyogenes  aureus  was  found 
in  the  discharges  during  the  secondary  fever,  and  in  an  acute  otitis  media  occurring  during  convales- 
cence the  B.  pyocyaneus  and  a  diplococcus  were  obtained  in  culture  from  the  aural  discharge.  This 
patient  recovered. 

(6)  "P.F."  (No.  3). — Admitted  on  the  fifteenth  day  of  illness.  Crisis  on  the  eighteenth  day  was 
followed  by  sixteen  days  of  intermittent  pyrexia.  Examination  of  the  bubo  on  admission  showed  the 
presence  of  the  B.  pestis  and  no  other  organism,  both  on  direct  examination  and  from  culture. 
Sloughing  of  the  biibo  took  place  on  the  twenty-third  day  of  illness,  and  from  the  discharge  the 
staphylococcus  aureus  and  albus  witii  a  small  putrefactive  bacillus  were  obtained,  but  no  B.  pestis, 
even  ou  direct  microscopical  examination. 

(c)  "J.B."  (No.  1). — In  this  case  a  prolonged  secondary  fever  preceded  death,  and  after  death 
cultures  made  from  the  bubo  yielded  luxuriant  growths  of  a  small  putrefactive  bacillus,  from  the 
midst  of  which  the  B.  pestis  was  recovered  with  great  difficulty.  In  the  spleen  the  B.  pestis  was 
likewise  scanty,  and  was  associated  with  large  numbers  of  the  staphylococcus  pyogenes  albus. 

Two  cases  (B.M.,  No.  28,  and  M.G.,  No.  27)  terminated  fatally,  in  which  death 
seemed  to  occur  from  a  pure  infection  of  the  B.  pestis.  In  the  latter  case  a  2)ost- 
mortem  examination  was  refused,  while  in  the  former  no  other  organism  was 
recovered  after  death  save  only  the  B.  coli  communis,  which  can  scarcely  be 
regarded  as  a  double  infection,  seeing  that  it  is  almost  constantly  met  with  in 
cultivations  made  from  the  cadaver. 

As  mentioned  above,  it  was  almost  impossible  in  the  extremely  mild  cases  of 
plague  to  puncture  the  affected  glands,  on  account  of  their  small  size  and 
frequently  deep  situation.  In  one  case,  that  of  the  wardmaid  (E.R,  No.  21),  where 
the  glands  affected  were,  although  small,  in  the  occipital  region,  and  therefore 
easily  accessible,  puncture  showed  the  presence  of  the  B.  pestis  in  pure  culture. 


59 


THE  SEROTHERAPEUTICS  OF  PLAGUE. 
By  John  Brownlee,  M.A.,  M.D.(Glasg.),  D.P.H.(Camb.). 

In  giving  an  account  of  my  experience  of  the  treatment  of  patients  suffering 
from  plague  with  Yersin's  serum,  as  received  from  the  Pasteur  Institute  of  Paris, 
it  may  be  well  to  point  out  that  the  disease,  as  it  occurred  in  Glasgow,  was 
apparently  of  a  much  milder  type  than  that  usually  seen  in  the  East  The 
number  of  cases  was  too  small  to  admit  of  statistical  comparison  between  those 
treated  with  the  serum  and  those  not  so  treated,  and,  on  account  of  the  mild 
character  of  the  epidemic,  comparison  with  the  statistics  of  other  epidemics  in  other 
countries  is  not  possible.  Consequently  the  value  of  the  treatment  can  only  be 
gauged  by  a  careful  consideration  of  each  case  in  detail. 

The  first  two  cases  in  which  the  serum  was  given  were  those  of  T.  H.  and 
C.  M.  (Cases  No.  9  and  19).  In  both  these  cases  the  only  organism  obtained 
in  puncturing  the  buboes  was  the  bacillus  pestis.  The  first  of  these  cases  belonged 
to  the  septicsemic  variety  of  plague,  with  multiple  bubo.  The  prognosis  was  bad. 
Within  36  hours  of  the  administration  of  the  serum  the  temperature  nearly  fell 
to  normal,  and  the  patient  was  apparently  out  of  danger.  In  the  second  case, 
which  appeared  to  be  an  example  of  the  fulminant  type  of  plague,  an  injection 
of  20  c.c.  of  the  serum  intravenously,  and  of  a  like  amount  sub-cutaneously, 
was  followed  within  24  hours  by  a  complete  cessation  of  symptoms.  Both 
patients  were  excessively  ill,  and  in  both  the  subsidence  of  the  symptoms  was 
marked  and  immediate.  There  were,  it  is  true,  some  cases  of  plague  untreated 
by  the  serum  in  which  thei-e  was  a  critical  fall  in  the  temperature ;  but  in  these 
the  disappearance  of  the  mental  obscuration  which  accompanied  the  fever  was 
much  more  gradual,  and  the  convalescence  more  tedious.  In  both  the  cases  under 
consideration,  a  symptom  was  present  not  observed  in  any  of  the  other  cases  which 
terminated  by  crisis,  viz.,  a  few  hours  after  the  injection  a  copious  sweating 
occurred  over  the  whole  body. 

The  next  three  persons  treated  by  serum  suffered  from  a  milder  type  of  the 
disease;  in  only  one  was  the  prognosis  doubtful.  The  first,  Mrs.  B.,  No.  20,  was  a  case 
with  right  inguinal  bubo,  from  which,  on  puncture,  a  pure  culture  of  bacillus 
pestis  was  obtained.  The  patient  on  admission  did  not  seem  sufficiently  ill  to 
require  an  injection  of  the  serum,  but  two  days  later,  as  the  symptoms  had  con- 
siderably advanced,  20  c.c.  of  the  serum  were  injected  subcutaneously  into  the 
abdominal  wall.  The  next  day  the  symptoms  had  somewhat  abated.  The  jmin  in 
the  bubo  was  less,  and  the  reddening  of  the  skin  over  the  swelling  was  not  so  marlfed. 
In  the  evening,  however,  the  patient's  condition  was  again  not  so  good,  and  by  the 
following  morning  the  temperature  had  again  risen.  The  local  condition  had 
advanced,  and  the  infectious  process  had  extended  so  as  to  involve  the  lymphatic 
glands  above  Poupart's  ligament,  and  also  the  deep  inguinal  glands.  A  further 
injection  of  20  c.c.  of  the  serum  was  then  given,  this  tune  into  one  of  the  veins  of  the 
right  arm.  An  immediate  improvement  was  noted  Six  hours  after  the  administra- 
tion of  the  serum  the  temperature  had  become  normal,  and  on  this  occasion  no 
subsequent  rise  took  place  such  as  had  occurred  after  the  former  dose  administered 
subcutaneously.  In  a  second  instance  the  result  was  equally  interesting.  The 
case  was  that  of  M.  M.,  No.  24.  This  patient,  a  girl  of  14  years  of  age,  suffered 
from  a  bubo  in  the  left  axilla.  The  point  of  entry  of  the  infection  Avas  evidently 
located  in  the  back,  where,  as  described  in  the  full  report,  a  small  pustule  was 
situated,  which  was  proved  bacteriologically  to  contain  the  plague  bacillus.  The 
external  local  condition  afforded  a  visible  index  by  which  the  therapeutic  effect  of 
the  remedy  could  be  gauged.  Here  again  a  subcutaneous  injection  of  the  serum 
was  followed  by  a  temporary  improvement  as  regards  the  bubo,  the  pain  being  con- 


60 


siderably  less  on  the  next  day,  but  no  improvement  could  be  seen  in  the  pustule 
above-mentioned.  A  recrudescence  of  the  disease  occurred  likewise  in  this  case, 
with  a  rise  of  temperature  to  102°  F.  A  second  pustule  began  to  form  on  the  back, 
while  the  erythematous  zone  surrounding  the  first-occurring  pustule  became  rather 
larger.  Here  again  the  intravenous  injection  of  the  serum  in  a  dose  of  20  c.c.  was 
followed  by  an  immediate  improvement.  Within  24  hours  a  slough  in  the  centre 
of  the  original  pustule  had  separated,  and  the  inflammatory  zone  had  almost  dis- 
appeared, while  the  second  commencing  pustule  had  completely  aborted.  The 
patient  six  hours  after  the  administration  of  the  last  dose  of  serum  spontaneously 
expressed  herself  as  feeling  very  much  better.  The  temperature  by  the  same  time 
had  fallen  to  normal,  and,  as  in  the  other  case  just  mentioned,  it  remained  so  without 
subsequent  rise.  Convalescence  from  this  point  was  rapid  and  uninterrupted.  The 
third  case  belonging  to  this  group  was  that  of  Mrs.  M.,  No.  23.  This  patient,  the 
mother  of  the  preceding,  was  aged  41.  She  had  a  right  inguinal  bubo.  On 
admission  the  temperature  was  102°'4  F.,  the  pulse  was  104,  and  the  respirations 
were  2  k  The  patient  was  evidently  ill,  though  a  fatal  issue  was  not  expected.  A 
subcutaneous  injection  of  20c.c.  of  the  serum  produced  almost  no  effect,  but  there 
was,  if  anything,  next  day  a  lessening  of  the  pain  in  the  bubo.  Thirty-six  hours 
later  a  second  injection  of  20c.c.  was  given  intra- venously.  As  in  the  other  two  cases 
just  noted,  there  was  observed  an  almost  immediate  improvement,  the  patient 
expressing  herself  as  being  much  better  six  hours  after  the  remedy  had  been 
administered.    The  temperature  fell  to  normal  within  24  hours,  and  remained  there. 

The  points  to  be  noted  with  regard  to  all  these  are,  that  the  subcutaneous 
injection  of  the  remedy  produced  little  effect,  and  that  of  a  temporary  nature, 
while  the  administration  of  the  serum  intravenously  was  followed  in  each  case  by 
an  improvement  which  was  easily  seen  in  the  subsidence  of  the  signs  of  illness,  and 
which,  besides,  was  spontaneously  borne  witness  to  by  the  patients  themselves. 

The  serum  was  also  administered  to  four  persons  in  whom  the  disease  pro- 
gressed to  a  fatal  issue.  One  of  these  needs  no  mention,  as  he  did  not  come 
under  treatment  till  the  fourth  week  of  the  illness,  at  which  period  an  extensive 
secondary  pyogenic  infection  of  the  sloughing  bubo  had  occurred.  Each  of  the 
other  three  require  special  note.  The  first  of  these  in  point  of  time  was  Mrs. 
M.,  case  No.  22).  She  had  for  some  time  prior  to  the  onset  of  illness 
experienced  considerable  privation.  On  admission  she  was  extremely  ill,  and 
premature  labour  was  in  progress.  No  apparent  benefit  resulted  from  the 
administration  of  the  remedy,  the  patient  dying  within  about  three  days 
from  the  commencement  of  the  illness.  In  this  case  serum  was  administered 
on  the  evening  of  admission — 20  c.c.  into  a  vein  of  the  right  arm  and  20  c.c. 
into  the  subcutaneous  tissue  of  the  flexure  surface  of  the  left  thigh,  so 
that  it  might  drain  directly  into  the  bubo,  which  was  situated  in  the  left  groin. 
Next  day  20  c.c.  additional  was  administered  into  the  subcutaneous  tissues  of 
the  abdomen.  Though  only  the  plague  bacillus  was  obtained  on  culture  from 
the  bubo  in  this  case  both  before  and  after  death,  yet  in  the  retroperitoneal 
glands  it  was  demonstrated  that  the  infection  was  a  mixed  one,  as  considerable 
numbers  of  colonies  of  a  dipplococcus,  staining  by  Gram's  method,  were  seen  on 
section  of  these.  This  patient  was  so  enfeebled  by  the  privation  which  she  had 
undergone  that  she  would  in  all  probability  not  have  survived  her  confinement,  apart 
from  the  attack  of  plague.  So  that,  both  because  the  case  was  not  uncomplicated, 
and  because  of  the  patient's  weakness,  the  result  cannot  be  said  to  weigh  one  way  or 
the  other  in  appraising  the  value  of  the  serum  treatment.  But  it  must  be  noted,  as 
indicating  that  the  serum  had  some  considerable  influence  on  the  organism,  that  the 
bubo  revealed,  on  examination  after  death,  no  plague  bacillary  forms  which  did  not 
bear  evidence  of  the  most  profound  degeneration,  while  those  obtained  from  the 
other  organs  of  the  body,  showed  no  evidence  of  being  in  any  way  altered.  On  the 
same  day  the  brother  of  this  patient  was  admitted  (R.M.,  Case  No.  25).  Here  also 
the  infection  was  from  the  first  of  a  mixed  nature.    When  in  the  course  of  the 


61 


.second  week  of  illness  one  of  the  buboes  had  proceeded  to  abscess,  the  only  organism 
recovered  from  the  discharge  after  incision  was  the  staph,  pyog.  aureus,  and  that  in 
great  numbers.  As  there  were  no  means  of  infection  of  this  bubo  prior  to  its 
incision,  it  is  highly  probable,  considering  the  septic  course  of  the  temperature, 
that  the  double  infection  was  primary.  Of  all  the  cases  treated  with  the  serum  at 
the  beginning  of  the  illness  this  is  the  only  one  in  which  no  effect  of  any  kind  was 
noted. 

The  only  other  case  in  which  the  serum  was  administered  was  that  of  M.  G. 
(Case  No.  27).  This  was,  though  fatal,  one  of  the  most  interesting  in  some  of  its 
features.  The  patient  was  a  child  six  years  old.  Puncture  of  the  bubo  in  the 
right  groin  on  admission  resulted  in  the  discovery  of  the  plague  bacillus  in  its 
typical  forms.  On  admission  she  was  profoundly  ill,  and  in  a  state  of  almost  com- 
plete unconsciousness.  When  disturbed  she  cried  out  harshly  and  struggled  to  be 
let  alone,  but  otherwise  took  no  notice  of  her  environment.  As  recorded  in  the 
reporc,  intravenous  injection  was  attempted  without  success,  but  in  the  first  48 
hours  after  admission  she  received  100  c.c.  of  the  serum  into  the  subcutaneous 
tissues,  chiefly  of  the  lower  part  of  the  abdomen.  On  the  morning  of  the  fourth 
day  after  admission  a  marked  improvement  was  noted,  in  so  much  that  the  child 
for  the  first  time  recognised  her  mother,  and  smiled  to  her.  From  this  point, 
however,  there  was  a  rapid  advance  in  the  gravity  of  the  case,  and  death  supervened, 
with  the  usual  symptoms  of  heart  failure,  on  the  eighth  day  of  illness.  The  same 
appearance  was  noted  in  this  case  as  in  that  of  Mrs.  M.  (Case  No.  22)  above 
referred  to,  namely,  that  the  bacilli  found  in  the  bubo  which  received  the  strain  of 
a  large  part  of  the  serum  administered,  was  marked  by  degeneration,  while  those  in 
the  deeper  organs  of  the  body  were  unaffected  and  very  virulent. 

A  general  review  of  the  action  of  Yersin's  serum  falls  to  be  considered  under 
two  heads — First,  by  the  prophylactic  action  ;  and  second,  by  the  curative  action. 

1.  The  Protective  Action  of  the  Anti-plague  Serum. — Of  the  healthy  persons 
who  had  been  in  contact  with  plague,  and  who  received  a  prophylactic  injection  of 
the  anti-plague  serum,  two  developed  the  disease.  One  of  these  was  a  maid 
attached  to  the  service  of  the  plague  wards.  From  her  buboes  the  specific  bacillus 
of  plague  was  recovered,  and  at  the  appropriate  time  after  the  disease  was  over,  her 
blood  gave  the  typical  agglutinative  reaction  in  a  marked  degree.  The  other  was 
the  mother  of  one  of  the  fatal  cases  noted  above  (Mrs.  G.,  Case  No.  26).  The 
latter  during  the  course  of  the  disease  ran  a  fairly  high  pyrexia,  but  she  never  gave 
the  impression  that  she  was  dangerously  ill.  The  three  factors  which  might  have 
contributed  to  produce  this  high  temperature  are  noted  in  the  full  report. 
These  two  cases  prove  that  a  dose  of  10  c.c.  of  Yersin's  serum  administered  subcu- 
taneously  does  not  afford  complete  protection,  yet  it  is  a  fair  presumption  that  a 
certain  degree  of  immunity  is  afforded,  as  the  syinptoms  in  both  cases  were  of  great 
mildness.  This  corresponds  with  what  has  been  frequently  observed  with  regard 
to  the  action  of  diphtheria  anti-toxin  when  used  as  a  prophylactic.  Immunity  is 
not  a  certainty,  but  if  the  disease  becomes  established  the  attack  is  almost  certain 
to  be  slight. 

No.  2.  Curative  Action. — A  general  review  of  the  facts  given  above,  and  a 
consideration  of  the  reports  of  the  individual  cases,  will,  I  think,  justify  the 
following  conclusions : — Firstly,  that  subcutaneous  injection  is  not  of  any  great 
curative  value.  This  is  probably  not  due  to  the  blocking  of  the  lymphatics  during 
an  attack  of  plague,  as  has  been  suggested  by  some,  in  view  of  the  fact  that 
absorption  of  the  serum  by  healthy  persons  is  no  more  rapid  than  that  seen  in 
the  plague  patients.  The  failure  in  action  is  therefore  much  more  likely  the 
result  of  the  lymphatic  system  exercising  a  distinct  action  as  a  biological  filter 
on  the  serum,  such  as  exists  in  the  organs.  In  this  way  the  antitoxic  substances  of 
the  serum  are  retained  largely  in  the  glands  which  drain  the  area  into  which  the 
injection  is  given,  so  that  only  the  more  inert  portions  of  the  serum  reach  the 
general  circulation.    It  was  noticed  that  the  lymphatic  glands  connected  with  the 


area  into  which  the  injection  was  made  in  healthy  persons  enlarged  for  some  days 
thereafter.  This  is  not  a  proof  that  such  a  filtering  action  as  above  indicated  takes 
place,  yet  it  shows  that  some  constituent  of  the  serum  having  an  irritant  action  is 
retained,  and,  if  the  glands  possess  the  power  of  filtering  out  certain  ingredients  of 
the  serum,  there  is  no  reason  to  doubt,  in  the  light  of  what  has  gone  before,  that 
this  may  include  the  active  anti-toxin.  The  case  of  Mrs.  M.  (Case  No.  22)  lends  some 
clinical  supj^ort  to  this  view.  The  inguinal  bubo,  into  the  drainage  area  of  which 
the  serum  had  been  injected,  showed  post-mortem  evidence  of  a  potent  local  effect 
in  the  marked  degeneration  of  the  bacilli,  while  the  organisms  found  in  other  parts 
of  the  body  were  quite  normal.  It  is  therefore  evident  that  subcutaneous  injection 
of  the  serum  can  be  efficient  only  in  cases  where  the  infection  is  localised  to  a  bubo 
and  has  not  become  general.  Secondly,  the  intravenous  injection  of  the  serum 
seems,  in  most  cases,  to  produce  a  most  marked  therapeutic  effect,  even  when 
given  late  in  the  disease.  This  is  exemplified  in  the  case  of  T.  H.  (Case  No.  9), 
where  it  was  administered  on  the  eleventh  day  of  illness.  In  those  cases, 
however,  where  double  infection  has  existed  from  the  beginning  its  action  is  greatly 
lessened. 

In  conclusion,  it  is  probable  that  the  doses  given  were,  in  general,  too  small  - 
and  should  an  opportunity  again  arise  of  using  this  remedy,  large  initial  doses  of 
60  c.c.  and  upwards  would  be  given  intravenously.  Probably  it  would  be  advisable, 
if  using  the  serum  subcutaneously  at  all,  to  inject  it  only  into  the  area  drained  by 
the  lymphatic  system  which  leads  directly  to  the  bubo. 


ON  THE  AGGLUTINATING  PROPERTY  OF  BLOOD  SERUM  IN  CASES  OF  PLAGUE. 

By  D.  Louis  Caibns,  M.B.(Glasg.), 
Resident  Assistant  Physician,  City  of  Glasgow  Fever  Hospital,  Belvidere. 

Q'he  number  of  observations  which  have  been  made  up  to  this  time  on  the  aggluticative  power  of 
serum  from  patients  in  the  course  of,  or  during  convalescence  from,  an  attack  of  bubonic  plague  is 
comparatively  limited.  This  is  all  the  more  remarkable  when  one  considers  the  numerous  opportunities 
which  have  occurred  during  the  last  five  or  six  years  for  such  observations.  The  literature  also  bearing 
on  the  subject  is  not  at  present  of  such  extent  or  completeness  as  to  furnish  a  basis  for  inferences  of 
practical  value.  The  earliest  reference  to  this  part  of  the  subject  which  I  have  been  able  to  find  is 
contained  in  the  report  of  the  German  Commission  sent  to  Bombay  for  the  investigation  of  plague. 
In  their  abstracted  report,  published  in  the  Deutsche  Medici n.ische  Wochenachrift  for  1897,  the  existence 
is  announced  of  a  definite  reaction  between  the  serum  of  man  and  animals  infected  with  plague  and  an 
emulsion  of  the  specific  bacillus.  The  reaction  consists  in  the  precipitation  of  the  bacilli  in  the  form 
of  small  distinct  fioccules  when  such  serum  is  added  to  a  test  tube  containing  an  emulsion  of  plague 
bacilli.  The  report  also  states  that  no  such  precipitation  of  other  organisms  by  plague  serum  occurs, 
the  emulsion  of  these  remaining  uniformly  turbid.  The  report  of  the  Commission,  however,  makes  no 
mention  of  the  value  of  the  reaction  either  as  a  diagnostic  or  prognostic  agent  in  this  disease,  and 
suggests  merely  that  the  specificity  of  the  reaction  may  constitute  a  reliable  method  for  the  iden- 
tification of  the  plague  bacillus  and  its  differentiation  from  other  organisms  closely  resembling  it. 
Ab.)ut  the  same  time  Paltauf^  established  the  existence  of  the  reaction  in  the  blood  of  animals  (guinea 
pigs  and  horses)  which  had  succumbed  to  inoculations  of  dead  plague  cultures.  A  very  slight  degree 
of  dilutiim  of  the  blood,  however  (from  1  to  5  or  even  1  to  1),  was  employed — a  fact  which  tends  to 
diminish  the  value  of  the  observations.  Considerably  greater  practical  importance  attaches  to  the 
results  obtained  by  Wyssokowitz  and  Zabolotny.  -  These  authors  state  that  the  agglutinative  power 
is  not  manifest  during  the  earliest  and  most  acute  stage  of  the  disease.  It  first  appears  in  the  blood 
about  the  sevsnth  day  of  illness,  gradually  increases  up  till  the  fourth  week,  and  declines  after  this 
period.    In  cases  fatal  during  the  first  week  of  illness  they  found  it  absent. 

A  short  r4mm4  of  the  results  obtained  independently  by  Professor  Zabolotny  during  the  epidemic 
at  Bombay  in  1897  appeared  in  ihe  Deutsche  Medicinische  Wochenschrifi  for  the  same  year,^and  though 


■  Wiener  Klinische  Wothenschiift,  1897,  p.  637  ;  also  La  Semaine  M^dicale,  June  2n(i,  1897. 
»  Archives  Kusscs  de  Pathologie,  May,  1897.    Recherches  sur  la  Pestc  Bubonique,  Annales  de  I'lnstitut  Pasteur,  No.  8, 
p.  663,  1897. 

2  Uber  agglutigirende  Eigenschaf ten  dcs  llensthenblutserums  bei  der  Pest,  Deutsche  Medicinische  Wochenschrifi,  189:, 
No.  24,  p.  39l'. 


63 


no  details  are  given  the  conclusions  to  which  he  has  been  led  substantially  a^ee  with  those  of  the  last- 
mentioned  observers.  In  a  subsequent  paper^  the  method  employed  for  demonstrating  the  reaction  is 
stated,  and  from  a  comparatively  large  number  of  single  observations  the  probable  curve  of  the  agglu- 
tination wave  is  constructed.  I  desire  here  to  acknowledge  my  indebtedness  to  Professor  Zabolotny, 
to  whom,  during  his  stay  in  Glasgow,  I  owed  several  valuable  suggestions  in  the  carrying  out  of  my 
work  on  this  subject.  Dr.  Leumann,  of  the  Bombay  Plague  Laboratory,  has  also  made  a  considerable 
number  of  single  observations  on  the  bactericidal  and  agglutinative  properties  of  plague  serum,  and 
while  the  technique  adopted  was  sufficient  for  the  demonstration  of  the  former  property  and  for  rough 
estimations  of  the  latter,  it  was  evidently  quite  impossible  to  obtain  reliable  comparative  data  by  this 
method.  One  or  two  loopfuls  of  an  agar  culture  were  simply  suspended  in  sterile  water  and  serum 
was  added  drop  by  drop  till  precipitation  of  the  microbes  occurred.  No  attempt  was  made  to  estimate 
the  relative  proportions  of  seium  and  emulsion,  and,  as  will  be  shown  later,  the  sine  qua  non  of  all 
agglutinative  experiments — viz.,  a  perfectly  homogeneous  emulsion — cannot  be  obtained  by  this 
method.  A  short  paper  by  Dr.  E.  Klein-  completes  the  list  of  those  which  I  have  hitherto  been  able 
to  consult.  In  it  he  mentions  the  difficulty  and  empha.?ises  the  importance  of  obtaining  a  perfectly 
homogeneous  distribution  of  the  bacilli  in  the  emulsion  to  be  used,  (This  is  referred  to  in  a  later  part 
of  the  present  paper.)  The  extensive  report  of  the  Austrian  Commission  contains,  so  far  as  I  am 
aware,  no  reference  to  this  aspect  of  the  subject,  and  the  comparativelj'  short  paragraph  devoted  to  it 
in  the  exhaustive  work  of  the  late  Dr.  MilUer,  of  Vienna,"  is  indicative  of  the  necessity  for  extending 
our  observations  on  the  subject. 

The  recent  outbreak  of  bubonic  plague  in  Glasgow  provided  an  opportunity  of  furnishing  an  addi- 
tional contribution  on  the  character  and  significance  of  the  agglutinative  phenomenon  in  this  disease. 
It  has  been  my  desire  to  gauge  as  accurately  as  possible  the  degree  of  completeness  of  the  reaction  at 
several  stages  of  the  disease  in  the  same  individual,  so  that  a  basis  for  the  estimation  of  its  value  at 
any  particular  period  may  be  established.  The  following  record  contains  particulars  of  24  cases 
examined  with  this  specially  in  view,  and  considerably  over  ."^OO  agglutination  tests  have  been  per- 
formed to  furnish  tlie  strictly  comparable  data.  The  fact  that  the  entire  series  of  observations  was 
made  by  nij'self  is  mentioned  only  to  indicate  that  the  standard  nf  comparison  by  naked-eye  examina- 
tion of  all  the  reactions  has  been  practically  uniform  throughout. 

Unfortunately,  many  of  the  earlier  agglutinative  experiments  performed  with  plague  serum  m  this 
research  were  rendered  of  comparatively  little  value,  owing  to  the  fact  that  a  mode  of  procedure  was 
adopted  similar  in  all  respects  to  that  now  in  common  use  for  obtaining  the  agglutinative  reaction  in 
enteric  fever.  The  method  adopted  for  the  latter  purpose  becomes  inapplicable  to  plague  because  the 
specific  bacillus,  unlike  that  of  enteric  fever,  does  not  produce  in  peptone  bouillon  a  homogeneous 
turbidity  during  growth,  but  tends  to  cohere  either  in  the  form  of  strands  of  varying  lengths  ("  stalac- 
tites") or  as  minute  floccules  which  are  aggregated  mainly  on  the  sides  and  bottom  of  the  tube,  and 
to  a  lesser  extent  occur  throughout  the  fluid  medium,  It  was  found  impossible  by  means  of  prolonged 
agitation  of  such  a  culture  to  produce  a  homogeneous  suspension  of  the  bacilli.  After  such  treatment 
the  micro-organisms  were  found  to  settle  at  the  bottom  of  the  tube  in  the  form  of  a  loose  powdery 
deposit,  and  on  microscopical  examination  clumps  of  minute  size  were  found  throughout  the  super- 
natant fluid.  The  most  important  condition  for  the  performance  of  a  trustworthy  series  of  experiments 
in  agglutination  or  sedimentation — viz.,  an  absolutely  liojiiogeneous  emulsion  of  the  young  organism — 
is  therefore,  in  the  case  of  bacillus  pestis,  unobtainable  with  peptone  bouillon.  The  cohesion  of  the 
bacilli  during  growth  in  bouillon  (possibly  related  to  the  development  of  an  adhesive  agent  connected 
with  the  capsules  of  the  organisms  by  which  zoogloea-like  masses  are  formed)  is  also  exhibited  during 
growth  on  the  surface  of  agar-agar.  If  the  surface  of  such  a  culture  of  24  hours'  incubator  growth  be 
touched  with  a  platinum  loop  its  slimy  consistence  becomes  at  once  apparent,  and  while  the  needle  is 
being  removed  a  fine  gelatinous  thread  is  drawn  out  from  the  growth  on  the  tip  of  the  wire.  This 
becomes  a  more  marked  feature  in  slightly  older  cultures.  The  difficulty  in  obtaining  such  an  enuil- 
sion  of  plague  bacilli  was  one  which  entailed  a  considerable  amount  of  experimental  work.  It  was 
ultimately  found  that  a  homogeneous  emulsion  could  be  obtained  in  sterile  0'7o  per  cent,  salt  solution. 
It  is  noteworthy  that  Dr.  Klein,  whose  paper  on  the  subject  has  recently  appeared,  has  solved  the 
same  difficulty  after  trial  of  various  expedients  in  an  almost  precisely  similar  manner.  This  method 
yields  a  perfectly  homogeneous  and  workable  emulsion  which  remains  practically  unchanged  for  24 
hours  showing  no  signs  of  clarification  in  the  upper  portion  of  the  fluid  and  no  great  tendency  to  the 
deposition  of  micro-organisms  at  the  foot  of  the  tube.  A  drop  of  this  fluid  examined  imder  the  micro- 
scope shows  the  bacilli  perfectly  free  and  isolated  from  each  other,  and,  if  carefully  prepared,  ought  to 
be  entirely  free  from  any  clump-formations. 

The  following  was  found  the  most  suitable  method  of  preparing  the  emulsion,  which,  in  view  of 
the  necessity  of  obtaining  reliable  comparative  results  in  each  case,  was  required  in  considerable 
quantities.  Several  sloped  agar  tubes,  which  had  been  inoculated  from  a  24  hours'  culture  of  bacillus 
pestis,  were  incubated  lor  from  24  to  36  hours.  Cultures  which  showed  the  presence  of  involution 
forms  in  considerable  numbers,  or  which  had  been  incubated  for  longer  periods  than  48  hours,  were 
not  (and  should  not  be)  used  for  this  pui-pose.  The  tubes  were  then  tilled  with  sufficient  0'75  per  cent, 
sterilised  salt  solution  to  cover  the  solid  medium.  The  growth  was  then  as  far  as  possible  transferred 
to  the  salt  solution.  This  was  carried  out  most  efficiently  and  without  tearing  the  surface  of  the  agar 
in  the  process  by  rubbing  the  growth  with  the  rounded  extremity  of  a  sterile  Pasteur  pipette,  the  end 
of  which  had  been  previously  curved  in  the  form  of  a  sliepherd's  crook.    The  various  eriuilsions  so  pre- 


■  Recherches  sur  la  Peste,  Zabolotny,  Archives  des  Sciences  Biologiques,  April,  1900,  T.  viii.,  No.  1. 
2  The  Lancet,  fob.  Ifitli,  liJOl,  p,  4;G.  Hie  Pest  von  Miiller  und  POch,  1001, 


64 


pared  were  then  decanted  into  a  large  sterilised  test  tube,  which  was  set  aside  for  a  short  time  to 
allow  any  cohering  masses  which  might  be  present  to  settle.  If  the  growth  had  been  very  luxuriant 
a  more  sensitive  emulsion  was  usually  obtained  by  diluting  still  further  with  salt  solution.  The  exact 
degree  of  dilution  with  salt  solution  is  undoubtedly  a  matter  of  some  importance  and  cau  only  be 
determined  after  consideraV)le  experience  in  agglutinative  work.  As  a  matter  of  frequent  observation 
it  may  be  stated  that  too  concentrated  emulsions  are  agglutinated  very  slowly  and  often  very  imper- 
fectly. In  the  following  series  of  observations  the  emulsions  were  all  prepared  from  the  same  stock 
cultures,  incubated  for  approximately  the  same  length  of  time,  and,  as  far  as  possible,  grown  under 
exactly  similar  conditions.  It  need  hardly  be  added  that  the  cultures  used  responded  to  all  the 
recognised  tests  for  the  complete  identification  of  the  bacillus  pestis.  Inoculation  of  animals  with 
these  cultures  reproduced  the  disease  with  its  characteristic  lesions,  and  after  death  the  specific 
bacillus  was  recovered  from  the  blood  or  organs. 

In  performing  experiments  on  agglutination  two  chief  methods  are  recognised:  (1)  the  micro- 
scopical and  (2)  the  macroscopical  or  sedimentation  method.  The  result  of  a  considerable  number  of 
C" mparative  trials  of  both  methods  indicated  that,  on  the  whole,  the  latter  yielded  more  reliable  data. 
By  means  o£  the  microscopical  method,  however,  pronounced  aud  in  every  way  characteristic  reactions 
can  be  demonstrated  in  much  higher  dilutions  than  by  the  latter  technique,  but  data  so  obtained  are 
frequently  vitiated  by  the  occurience  at  times  of  puzzling  and  apparently  unaccountable  pseudo- 
reactions.  Consequently,  though  tlie  potency  of  a  given  serum  was  estimated  in  most  instances  by 
both  methods,  only  the  sedimentation  test  was  adopted  throughout  this  series  of  observations  as  the 
standard  for  performing  comparative  quantitative  estimations,  and  no  serum  was  regarded  as  yielding 
a  positive  result  which  failed  to  give  a  satisfactory  reaction  by  this  method.  The  reactions  were 
carried  out  with  serum  separated  directly  from  blood  collected  in  sterilised  Pasteur  pipettes,  care 
being  taken  in  every  possible  way  to  avoid  its  contamination.  By  so  doing  the  possible  introduction 
of  a  fallacious  factor  in  the  means  used  for  obtaining  serum  by  a  blister  was  avoided.  The  amount  of 
time  absorbed  in  the  careful  separation  of  serum  directly  from  blood  necessarily  limited  the  number 
of  observations  made.  It  may  be  stated,  however,  that  no  visible  difference  either  in  the  degree  of 
the  reaction  or  in  the  time  within  which  it  made  its  appearance  could  be  detected  in  several  instances 
where  serum  separated  from  blood  aud  that  obtained  from  a  blister  were  used  from  the  same  case  and 
at  the  same  date  for  purposes  of  comparison. 

Before  undertaking  a  consecutive  series  of  observations  it  is  well  to  prepare  beforehand  all  neces- 
sary apparatus,  so  that  no  delay  may  take  place  at  any  stage  which  might  interfere  with  or  vitiate 
the  comparative  value  of  individual  reactions.  Accordingly  it  was  found  advisable  to  have  in  readi- 
ness a  supply  of  ordinary  Pasteur  pipettes  about  30  centimetres  in  length  and  an  equal  number  of  a 
slightly  modified  pattern.  The  latter  were  provided  with  a  capillary  portion  of  a  length  equal  to  the 
distance  between  the  open  extremity  of  the  ordinary  Pasteur  pipette  and  the  commencement  of  its 
capillary  portion ;  in  addition,  a  constriction  or  neck  was  fashioned  on  the  upoer  end  of  the  tube  about 
three-quarters  of  an  inch  below  the  level  of  the  cotton  plug.  Blood  is  most  conveniently  obtained 
from  puncture  of  a  finger,  the  skin  being  first  rendered  sterile  according  to  recognised  methods.  All 
traces  of  antiseptics  having  been  removed  by  a  final  washing  with  spirit,  the  finger  is  carefully  dried 
with  aseptic  gauze,  and  the  pulp  punctured  with  a  sterilised  bayonet-pointed  needle.  The  drop  of 
blood  which  exudes  is  immediately  aspirated  into  a  sterilised  Pasteur  pipette,  the  sealed  extremity 
being  first  passed  through  a  flame  and  then  snapped  across  at  a  suitable  level  by  means  of  sterilised 
forceps.  By  "massaging"  the  finger  from  above  downwards  and  aspirating  each  drop  as  soon  as  it 
appears,  a  quantity,  sufficient  not  only  for  the  immediate  performance  of  the  reaction,  but  also  for 
purposes  of  comparison  subsequently,  can  usually  be  obtained.  In  this  way  from  half  to  one  cubic 
centimetre  of  blood  may  be  furnished  by  a  single  successful  puncture.  During  aspiration  care  should 
be  taken  to  avoid  the  introduction  of  any  air-bubbles,  as  these  interfere  to  some  extent  with  the 
formation  of  a  firm  coagulum  and  a  resulting  clear  seriim.  The  fine  extremity  of  the  tube  is  then 
sealed  by  drawing  it  out  in  a  spirit  flame,  unnecessary  heating  of  the  contents  being  carefully  avoided. 
The  pipette  is  kept  in  an  upright  position,  and  set  aside  in  a  cool  place  for  several  hours  pending  the 
separation  of  the  serum.  If  no  air  has  been  introduced  a  firm  coagulum  usually  forms  at  once  and 
may  be  seen  floating  in  the  centre  of  the  tube  surrounded  by  a  perfectly  clear  serum.  If,  however, 
during  the  process  of  aspiration  the  blood  has  been  more  or  less  churned  up  with  air,  then  it  is  better 
to  set  the  tube  aside  for  from  12  to  18  hours.  The  resulting  serum  in  this  case  is  apt  to  contain  a 
considerable  number  of  red  corpuscles,  and,  though  these  in  no  way  interfere  with  the  satisfactory 
performance  of  the  reaction,  a  clearer  serum  is  obtained  if  time  be  allowed  for  the  sedimentation  of  the 
red  corpuscles.  The  separation  of  the  serum  from  the  coagulum  is  effected  by  means  of  the  modified 
pipettes.  The  cotton-wool  plug  being  removed  from  the  tube  containing  the  blood,  the  sealed  ex- 
tremity of  a  modified  pipette  is  first  snapped  across  with  sterilised  forceps,  the  capillary  portion 
introduced  into  the  former  and  carried  down  to  the  conical  narrowing  of  the  tube.  The  clear  serum 
is  then  aspirated  into  the  second  tube,  and  the  capillary  portion  sealed  at  a  suitable  level  bv  drawing 
out  in  a  flame.  Before  doing  so,  however,  the  precaution  should  be  observed  of  aspirating  all  the 
fluid  into  the  body  of  the  tube  so  as  to  avoid  any  undue  heating  of  the  serum.  If  the  preservation  of 
the  serum  for  any  length  of  time  is  desired  the  pipette  may  easily  be  converted  into  a  hermetically- 
sealed  capsule  by  drawing  out  the  constricted  portion  in  a  Bunsen  flame.  On  accoimt  of  the  difficulty 
of  preparing  two  emulsions  of  exactly  the  same  density  it  is  always  better  to  subject  at  one  time  as 
large  a  number  of  sera  as  possible  to  the  influence  of  a  single  emulsion.  For  the  same  reason  when 
performing  quantitative  estimations  it  is  absolutely  necessary  to  compare  the  agglutinating  power  of 
the  serum  under  observation  with  that  obtained  at  a  previous  date,  the  potency  of  which  has  already 
been  ascertained  by  repeated  experiment.    Only  by  so  doing  is  it  possible  to  establish  an  arbitrary 


65 


standard  and  so  gain  an  accurate  conception  as  to  the  quantitative  value- of  individual  reactions.. 
When  results  materially  disagreed  with  previous  observations  the  data  so  obtained  were  disregarded, 
and  the  series  of  reactions  again  observed  with  a  fresh  emulsion. 

The  reaction  is  conveniently  performed  in  test  tubes  about  9  centimetres  in  length,  prepared  from 
ordinary  soft-glass  tubing  of  about  07  centimetre  internal  diameter.  These  are  thoroughly  cleansed 
and  dried,  the  open  extremity  being  closed  with  a  plug  of  cotton-wool.  After  sterilisation  at  a  tem- 
perature of  160°  C.  for  an  hour  they  are  ready  for  use.  In  all  cases  the  reaction  was  carried  out  in  at 
least  three  dilutions,  and  in  many  instances  with  sera  possessing  a  high  degree  of  potency  in  five  dilu- 
tions. The  proportions  adopted  throughout  have  been  1  in  10,  1  in  25,  1  in  50,  1  in  75,  and  1  in  100. 
In  no  case  has  an  undoubted  reaction  been  obtained  in  a  dilution  higher  than  1  in  75,  and  reactions 
lower  than  1  in  10  have  not  been  recorded,  as  the  necessarily  large  relative  dilution  of  serum  with  the 
emulsion  in  such  preparations  j'ields  a  practically  clear  fluid  in  which  the  determination  by  the  naked 
eye  of  any  agglutination  becomes  a  matter  of  extreme  difficulty. 

The  reaction  is  conveniently  performed  as  follows.  A  long  Pasteur  pipette  is  taken  and  its  capil- 
lary portion  snapped  across  at  a  level  corresponding  in  diameter  with  that  of  the  capillary  portion  of 
the  pipette  containing  the  serum  under  examination.  It  is  thus  ensured  that  drops  issuing  from  the 
orifices  of  these  two  pipettes  will  have  as  nearly  as  possible  the  same  volume,  and  in  this  way  any 
required  dilution  of  serum  with  emulsion  can  be  readily  performed.  The  Pasteur  pipette,  the  wider 
portion  of  which  is  guarded  by  two  cotton-wool  stoppers  to  prevent  possible  accidents  during  inspira- 
tion, is  filled  with  the  bacillary  emulsion.  A  drop  of  serum  having  been  introduced  into  each  of  a 
series  of  sedimentation  tubes  the  emulsion  of  bacilli  is  added  to  each,  drop  by  drop,  to  produce  the 
requisite  degree  of  dilution.  The  serum  and  emulsion  are  thoroughly  mixed,  and  the  cotton-wool 
stopper  is  replaced  in  the  sedimentation  tube.  It  is  convenient  to  place  vertically  in  a  small  deep 
box  the  requisite  number  (from  three  to  five)  of  sedimentation  tubes  for  each  serum  under  investiga- 
tion. This  obviates  the  necessity  of  labellins  each  tube,  and  at  the  same  time  prevents  confusion. 
The  degree  of  dilution  can  then  be  readily  inferred  from  the  volume  of  fluid  in  each  tube.  When  com- 
pleted the  whole  series  is  set  aside  in  a  cool  chamber  for  from  IS  to  2i  hours.  As  control  experiments 
in  each  series  two  or  more  tubes  containing  (1)  a  quantity  of  the  bacillary  emulsion,  and  (2)  emulsion 
-f  normal  serum  in  corresponding  dilutions  were  employed.  If  at  the  end  of  24  hours  any  degree  of 
sedimentation  had  taken  place  in  these  latter  the  data  obtained  from  this  series  were  not  recorded. 
Under  ordinary  circumstances,  however,  no  changes  were  observed  in  the  control  tubes,  whilst  in  the 
case  of  those  containing  serum  from  a  convalescent  plague  patient  a  remarkable  alteration  became 
apparent  after  a  variable  interval  of  time  and  according  to  the  potency  of  the  serum.  The  emulsion 
was  seen  to  clarify  from  above  downwards  till  practically  the  entire  column  of  fluid  became  absolutely 
clear.  This  change  was  due  to  the  precipitation  of  bacilli  to  the  lower  part  of  the  tube,  where  they 
form  a  loose  flocculent  deposit.  On  examining  this  bacillary  deposit  under  the  microscope  it  was 
observed  that  the  capsules  of  the  organisms  had  become  indistinct.  In  the  case  of  powerfully  agglu- 
tinative sera  the  process  m.-iy  be  observed  to  commence  after  one  or  two  hours,  but  as  a  rule  the 
reaction  is  rarely  completed  till  24  hours  have  elapsed.  Consequently  the  latter  has  been  adopted  as 
the  uniform  time  limit  throughout  this  series  of  investigations.  In  high  dilutions  or  when  dealing 
with  sera  of  feeble  agglutinative  power  the  reaction,  as  might  be  expected,  is  less  complete.  Com- 
parison with  the  control  tubes,  however,  show  that,  while  a  certain  degree  of  clarification  and  precipi- 
tation has  occurred  at  the  end  of  24  hours,  the  process  has  stopped  short  of  completion,  leaving  a 
slightly  opalescent  appearance  in  the  tube.  In  the  following  tables  such  reactions  are  indicated  by 
the  sign -t-f  (feeble),  as  the  precipitated  microbes  showed  the  same  microscopical  changes  as  incomplete 
reactions.  A  complete  reaction  is  indicated  by  the  positive  sign  +  whilst  the  negative  sign  —  indicates 
that  no  reaction  has  taken  place.  In  the  case  of  powerfully  agglutinative  sera,  when  clarification  of 
the  emulsion  occurs  soon  after  performing  the  dilution  (from  one  to  two  hours),  the  double  sign-f  + 
has  been  used. 

The  following  tables  represent  in  a  condensed  form  the  result  of  over  300  separate  agglutination 
tests  of  the  serum  taken  at  different  stages  of  the  illness  from  27  plague  patients.  Detailed  clinical 
histories  have  been  purposely  omitted  in  this  paper,  but  it  has  been  deemed  advisable  to  add  short 
clinical  r4su7n4s  of  those  mild  cases  in  which  bacteriological  confirmation  of  the  diagnosis  was  not 
available.  The  cases  examined,  with  one  exception,  which  will  be  referred  to  later,  were  all  of  the 
bubonic  type,  and,  of  these,  nine  received  at  one  time  or  other  varying  doses,  either  subcutaneously 
or  intravenously,  of  Yersin's  anti-plague  serum.  The  agglutinative  reactions  in  these  cases,  however, 
were  probably  not  modified  to  any  considerable  extent  by  the  previous  administration  of  the  serum 
for  curative  purposes.  In  support  of  this  it  may  be  here  remarked  that  the  blood  serum  of  individuals 
who  had  received  one  or  more  prophylactic  doses  of  this  serum  showed  no  evidence  whatever  of 
agglutinating  power.  It  is,  therefore,  highly  improbable  that  the  data  so  obtained  have  been  vitiated 
in  the  slightest  degree,  as  even  the  remedy  itself  when  mixed  with  a  highly  sensitive  emulsion  fails 
to  produce  any  visible  change  after  the  lapse  of  24  hours.  With  the  view  of  ascertaining  the  possible 
effect  of  a  mixed  infection  on  the  agglutinative  reaction  1  undertook  a  complete  bacteriological 
examination  of  most  of  the  organs  in  fatal  cases  of  plague.  These  results  are  appended  in  Table  I. 
Reference  to  the  cases  in  Table  II.  shows  that  the  presence  of  micro-organisms  other  than  the 
bacillus  pestis  in  the  blood  or  organs  of  a  patient  dead  from  bubonic  plague  does  not  prevent  the 
development  of  the  specific  reaction. 

For  purposes  of  classification  the  cases  have  been  arranged  in  the  following  groups. 

Table  II.  shows  the  results  obtained  from  six  fatal  cases,  in  all  of  which  the  presence  of  the  bacillus 
pestis  was  verified  by  reproducing  the  disease  with  its  characteristic  lesions  in  animals.  Cultures  of 
the  specific  bacillus  were  obtained  during  life,  either  from  the  bubo  or  blood  of  the  patient,  or  post 


66 


mortem  from  the  various  organs.  These  were  either  injected  subcutaneously  or  a  small  quantity  of  an 
agar  growth  placed  in  the  nasal  cavity  of  an  animal  and  the  bacillus  again  recovered  from  the  tissues 
after  its  death.  In  this  group  of  cases  the  reaction  was  also  demonstrated  with  other  body  fluids — 
viz.,  pleural  effusion,  pericardial  effusion,  peritoneal  fluid,  and  bile.  With  respect  to  the  first  three 
of  these  it  will  be  observed  that,  in  comparison  with  blood  serum,  a  relatively  high  degree  of  aggluti- 
nation has  been  noted  in  the  only  three  cases  in  which  it  was  possible  to  perform  the  test  with  these 
morbid  exudations. 

Table  III.  comprises  those  severe  cases  terminating  in  recovery,  from  all  of  which,  with  one  ex- 
ception (Mrs.  M.),  the  bacillus  pestis  was  obtained  by  puncturing  the  bubo.  A  sterilized  hypcdermio 
syringe  was  inserted  into  the  glandular  swelling,  and  from  the  serous  fluid  withdrawn  the  specific 
organism  was  demonstrated  on  direct  microscopical  examination  of  smear  preparations.  Culturally 
the  organism  isolated  from  each  case  responded  to  all  the  recognised  tests  for  the  identification  of 
Yersin's  bacillus,  and,  as  in  the  first  group  of  cases,  was  further  verified  by  the  biological  test.  In  the 
case  of  Mrs  M.  it  was  thought  unnecessary  to  perform  a  bacteriological  examination  of  the  bubo,  as 
the  patient's  daughter  (Mrs.  M.),  granddaughter  (baby  M. ),  and  son  (Robert  M.,  see  Table  II.),  all 
died  from  bubonic  plague.  A  special  report  regarding  the  last  case  in  this  table  is  given  on 
page  55. 

Table  IV.  comprises  those  comparatively  mild  cases  of  plague  with  characteristic  bubo.  From 
the  first  three  of  these  the  specific  organism  was  isolated  and  identified  as  above,  but  only  in  the  case 
of  Mrs.  G-.  was  the  proof  completed  by  animal  inoculation.  In  the  last  three  cases  (James  C,  Rosina 
M.,  and  Dennis  T. )  it  was  found  impossible  to  cultivate  the  organism  either  from  the  juice  obtained 
by  puncture  of  the  glands,  or  at  a  later  stage  when  the  bubo  had  broken  down  from  the  sero-purulent 
discharges.  The  failure  to  obtain  the  bacillus  in  these  cases  was  no  doubt  due  to  the  comparatively 
late  stage  of  the  illness  at  which  the  patients  first  came  under  observation.  As  the  disease  ran  an 
exactly  similar  course,  however,  to  those  from  which  the  specific  organism  had  been  recovered,  and  as 
in  each  instance  the  serum  possessed  marked  agglutinative  power,  there  appears  to  be  every  possible 
reason  to  regard  them  as  undoubted  though  mild  cases  of  plague.  The  following  synopsis  of  the 
clinical  features  of  these  cases  reveals  their  character  sufiiciently  : — 

Dennis  T.  (Case  6),  aged  5  years.  This  patient  was  admitted  on  the  eighth  day  of  illness 
with  a  glandular  swelling  in  the  right  inguinal  region  which  presented  the  characteristic  appearance 
of  a  plague  bubo  in  the  stage  of  resolution.  The  enlargement  was  limited  to  the  vertical  set  of 
glands,  the  skjn  over  and  around  it  being  inflamed  and  exceedingly  tender.  The  patient,  though 
not  acutely  ill,  was  drowsy  and  showed  a  lack  of  interest  in  his  surroundings.  Examination  of  the 
heart  and  lungs  revealed  nothing  noteworthy.  The  admission  temperature  of  100 '4°  F.  was  never 
exceeded,  and  a  few  days  later  the  patient  seemed  quite  well,  though  the  bubo,  while  less  tender, 
showed  no  signs  of  resolution.  On  the  sixteenth  day  of  illness  spontaneous  rupture  of  the  bubo  took 
place,  convalescence  thereafter  being  rapid  and  complete.  Cultures  from  the  bubo,  made  as  above 
described,  proved  sterile,  though  smear  preparations  showed  the  presence  of  numerous  degenerated 
bacilli.  No  doubt,  however,  can  be  entertained  as  to  the  nature  of  this  patient's  illness  both  on 
account  of  the  association  and  the  clinical  appearances.  The  patient's  grandfather  (James  B., 
Table  II.)  died  from  plague,  and  his  mother  (Mrs.  T.,  Table  III.)  passed  through  a  very  severe  attack 
of  this  disease.  The  identity  of  the  isolated  organisms  in  both  these  latter  cases  was  verified  by 
animal  experimentation. 

James  C.  (Case  4),  aged  24  years.  This  patient  was  admitted  to  hospital  on  August  30th,  1900. 
On  August  IGtli  he  was  seized  with  an  illness,  evidently  of  considerable  severity,  associated  with 
headache,  sickness,  and  vomiting,  and  pain  in  the  left  inguinal  region.  The  report  received  from  the 
medical  attendant,  Dr.  G.,  is  as  follows  : — On  August  17th  the  temperature  was  103°  F.,  and  the  pulse 
102.  There  was  severe  headache  with  vomiting.  The  patient  complained  of  pain  in  the  left  inguinal 
region,  where  there  were  some  redness  and  swelling.  On  tlie  21st  the  temperature  was  102'6°,  the 
pulse  98,  while  the  swelling  had  increased  in  size  and  was  still  painful.  On  the  24th  the  temperature 
was  100,  and  the  pulse  90.  The  swelling  was  sausage-shaped  and  lay  along  the  upper  border  of 
Poupart's  ligament ;  it  was  fairly  hard  and  pitted  on  pressure.  On  admission  the  patient  was 
evidently  convalescent,  no  sign  of  illness  being  present.  The  temperature  was  normal.  On  examina- 
tion of  the  left  groin,  however,  a  swelling  rather  larger  than  a  pigeon's  egg  was  discovered 
immediately  above  Poupart's  ligament,  and  evidently  involving  the  horizontal  set  of  glands.  The 
overlying  skin  was  inflamed  and  slightly  cedematous,  and  fluctuation  could  be  easily  obtained.  A 
hypodermic  needle  inserted  into  the  glandular  swelling  withdrew  a  quantity  of  dark  grumous  fluid, 
"which,  on  microscopical  examination,  showed  the  presence  of  numerous  degenerated  bacilli ;  and 
though  a  considerable  number  of  agar  tubes  were  inoculated  on  two  separate  occasions,  no  growth 
whatever  could  be  obtained.    Convalescence  was  uninterrupted,  the  bubo  disappearing  by  absorption. 

Rosina  M.  (Case  10)  was  admitted  from  the  plague -infected  area  in  her  third  week  of  illness.  At 
this  date  all  clamant  symptoms  had  subsided,  but  examination  of  the  inguinal  region  on  each  side 
showed  the  presence  of  a  bilateral  bubonic  condition  involving  the  group  of  glands  situated  imme- 
diately above  Poupart's  ligament.  Each  bubo  was  about  the  size  of  a  large  walnut,  that  on  the  left 
side  being  comparatively  firm  and  painless,  whilst  in  the  other  fluctuation  could  be  easily  detected. 
On  both  sides  the  overlying  skin  was  inflamed  and  adherent  to  the  glands  beneath.  The  history  of 
the  illness  obtained  from  various  sources  showed  that  the  onset  was  sudden  and  acute,  and  was 
characterised  by  high  fever  (temperature  104"^  F. ),  accompanied  by  rigors  and  delirium;  headache, 
sickness,  and  vomiting  were  also  present,  and  continued  for  some  time  after  the  appearance  of  the 
buboes,  which  were  discovered  by  the  patient  herself  on  the  third  day  of  illness.  These  were 
apparently  exceedingly  painful  at  this  stage.    They  rapidly  increased  in  size  during  the  succeeding 


67 


two  or  three  days,  after  which  the  tenderness  slowly  subsided.  The  bubqj.in  right  groin  ruptured 
spontoneously  in  the  fourth  week  of  illness,  discharging  a  sero-purulent  fluid  for  about  10  days, 
whilst  that  ou  the  left  side  underwent  resolution  without  rupture.  Both  buboes  were  explored  with 
a  hypodermic  needle  as  in  previous  cases,  and  culture  tubes  inoculated  with  the  aspirated  fluid 
remained  sterile.  At  a  later  date  the  subcutaneous  injection  of  a  mouse  with  the  discharges  from  the 
right  bubo  was  unattended  by  any  serious  disturbance  in  the  animal's  health. 

The  remaining  cases  grouped  in  Table  V.  may  be  regarded,  both  from  the  etiological  and  clinical 
standpoint,  as  fairly  typical  examples  of  pe.ttis  anibvhiiis.  In  all  the  illness  was  apparently  so  slight 
that,  apart  from  a  definite  history  of  contact  with  infected  persons,  and  in  the  absence  of  a  bacterio- 
logical examination,  it  would  have  been  quite  impossible  to  pronounce  upon  the  exact  nature  of  the 
glandular  affection.  The  general  course  and  s3'mptomatologj'  of  such  cases  has  already  been  described 
in  a  previous  article,  and  it  will  therefore  be  sufficient  here  to  indicate  briefly  the  salient  points  of 
each  case. 

Of  these  the  most  interesting  is  the  case  of  a  ward-maid  in  one  of  the  pavilions  set  apart  for  the 
isolation  and  treatment  of  plague  patients.  Ten  days  prior  to  the  commencement  of  her  illness  she 
had  received  a  prophylactic  injection  of  10  cubic  centimetres  of  Yersin's  serum.  The  illness,  however, 
was  of  a  comparatively  trifling  nature,  the  patient  only  complaining  of  a  moderate  degree  of  indisposi- 
tion for  about  three  days.  Bacteriological  examination,  however,  demonstrated  the  presence  of  the 
plague  bacillus  in  an  exceedingly  small  cervical  bubo.  The  serum  taken  during  the  third  week  of 
illness  agglutinated  an  emulsion  of  plague  bacilli  in  a  dilution  of  1  in  25,  though  the  constitutional 
disturbance  was  so  slight  that  the  temperature  and  pulse  throughout  the  illness  never  rose  above 
normal. 

-Agnes  R.  (Case  17),  aged  three  and  a  half  years.  This  patient  was  a  "contact"  from  the  Molloy 
wake — one  of  the  first  discovered  foci  of  infection.  The  illness,  of  sudden  onset,  was  accompanied  by 
headache,  sickness,  and  vomiting,  and  pain  in  the  left  axilla.  Examination  of  this  region  showed  the 
presence  of  a  small  bubo,  but  an  exploratory  puncture  failed  to  withdraw  any  lymphatic  gland  fluid. 
The  temperature  rose  to  101°  F.  on  the  first  day  of  illness,  and  subsided  to  normal  two  days  later. 
Convalescence  was  rapid  and  complete. 

In  the  remaining  three  cases  the  sudden  appearance  of  bubo  (axillary  in  one  case,  cervical  in  the 
others)  was  associated  with  symptoms  of  fairly  acute  onset,  similar  in  all  respects  to  those  already 
described.  In  these,  however,  a  bacteriological  examination  was  not  undertaken,  but  the  peculiar 
nature  of  the  illness,  taken  in  conjunction  with  a  very  definite  history  of  exposure  to  infection,  seems 
sufficient  to  warrant  these  cases  also  being  regarded  as  examples  of  the  mildest  variety  of  this  disease. 
It  may  here  be  added  that  the  serum  of  patients  suffering  from  various  forms  of  specific  infectious 
disease,  and  taken  at  various  stages  of  their  illness  was  examined  in  different  degrees  of  dilution  with 
an  emulsion  of  bacillus  pestis.  In  no  case  was  any  reaction  observed.  The  diagnostic  value  of  its 
appearance,  therefore,  in  oases  associated  with  slight  glandular  enlargement  is  to  this  extent 
enhanced. 

The  following  deductions  appear  fully  warranted  from  an  examination  of  the  accompanying 
tables  :  —  1.  During  the  earlier  days  of  the  disease  the  reaction  is  not  manifested,  and  consequently  in 
rapidly  fatal  cases  is  probably  never  obtained.  2.  Agglutinating  properties  first  appear  in  the  blood 
towards  the  close  of  the  first  week  of  illness  (dilution  1  in  10).  These  gradually  increase  in  intensity 
up  to  the  sixth  week  of  illness,  and  are  sometimes  maintained  at  a  high  level  as  late  as  the  eightli 
week.  After  this  date,  however,  in  the  majority  of  cases  a  gradual  decline  in  the  agglutinative  power 
of  the  serum  becomes  apparent.  The  rates  of  increase  and  decrease  of  the  reaction,  generally  speak- 
ing, are  approximately  equal  ;  occasionally,  however,  the  reaction  wanes  and  disappears  in  a  shorter 
period  than  that  occupied  between  its  appearance  and  point  of  maximum  intensity.  3.  In  very 
severe  cases  ultimately  proving  fatal,  the  reaction,  though  present,  never  reaches  a  high  degree  of 
intensity.  In  cases  of  almost  equal  severitj^,  however,  in  which  an  early  and  rapid  convalescence 
followed,  the  reaction  was  of  a  more  marked  character.  4.  In  the  mildest  forms  of  plague  a  high  degree 
of  agglutinating  power  is  probably  never  attained,  and  in  some  it  appears  to  be  absent.  Strieker,  in 
fact,  states  that  tlie  reaction  never  appears  in  this  class  of  case  ;  but  this  is  undoubtedly  too  sweeping 
an  assertion,  as  an  undoubted  and  characteristic  reaction  in  a  dilution  of  1  to  25  was  obtained  in 
two  such  cases.  5.  The  reaction,  as  a  rule,  is  most  marked  in  those  severe  cases  cliaracterised 
by  an  early  and  favourable  crisis,  and  in  such  cases  it  disappears  very  slowly,  having  been  shown 
to  be  present  as  late  as  the  fifth  month  after  the  primary  illness. 

Other  methods. — The  technique  just  described  is,  however,  perhaps  unnecessarily  complicated,  as 
in  order  to  avoid  any  possible  source  of  fallacy  a  number  of  precautions  were  adopted  which  later 
experience  showed  to  be  superfluous.  The  initial  difficulty — the  preparation  of  a  perfectly  homo- 
geneous bacillary  emulsion — having  been  overcome,  an  almost  precisely  similar  technique  to  tliat 
employed  in  the  ordinary  Widal  reaction  may  be  adopted.  As  already  stated,  the  dilution  of  serum 
with  emulsion  can  be  carried  to  a  much  higher  degree,  and  the  time-limit  considerably  shortened 
when  the  microscopical  method  is  employed.  By  this  means  reactions  in  which  the  bacilli  are 
completely  agglutinated  in  from  5  to  10  minutes  are  fairly  common  with  potent  sera  in  dilutions  of 
1  in  10  and  1  in  25.  If,  however,  the  dilution  be  carried  further,  it  is  absolutely  necessary  for 
trustworthy  results  to  observe  the  reaction  in  hanging-drop  preparations.  In  this  way  well-marked 
reactions  have  been  obtained  in  dilutions  of  1  in  200  with  a  time-limit  of  two  hours,  though  prepara- 
tions made  between  an  ordinary  slide  and  cover-glass  showed  no  evidence  whatever  of  any 
agglutinative  process.  The  time-limit  may  be  safely  extended  to  24  hours  if  the  edge  of  the  cover- 
glass  be  sealed  with  vaseline.  By  this  method  a  reaction  can  often  be  demonstrated  with  sera  of 
feeble  agglutinative  power,  or  with  potent  sera  which  have  been  highly  diluted.    As  a  control 


68 


experiment,  preparations  of  (1)  emulsion  and  (2)  emiilsion  plus  normal  serum  have  been  kept  for  over 
a  week  without  any  signs  of  undoubted  agglutination  supervening.  Numerous  observations  of  plague 
sera  in  progressively  increasing  dilutions  have  been  made,  and  the  time-limit  in  each  case  has  been 
carefully  noted.  The  data  so  obtained  may  be  compared  with  those  got  by  the  sedimentation  test  at 
corresponding  periods.  To  illustrate  this,  the  results  obtained  by  this  method  from  two  severe  cases 
of  plague  terminating  in  recovery  (Table  III.)  are  exhibited  in  the  accompanying  table  (Table  VI.). 

Like  results  may  be  obtained  with  similarly  prepared  emulsions  of  dead  plague  bacilli,  but  in 
this  case  the  reaction  is  not  so  reliable,  as  the  dead  organisms  are  not  agglutinated  so  readily.  When 
working  with  dead  cultures,  however,  the  microscopical  is  to  be  preferred  to  the  sedimentation 
method,  since  it  yields  more  trustworthy  results  even  in  higher  degrees  of  dilution.  In  the  absence 
of  facilities  for  obtaining  a  homogeneous  emulsion  of  living  or  dead  bacilli,  Haifkine's  prophylactic 
(which  contains  the  latter)  may  be  used  to  dilute  a  suspected  plague  serum.  No  satisfactory  reaction, 
however,  has  been  got  by  this  means  in  a  higher  dilution  than  1  in  25,  and  the  sedimentation  method 
is  alone  applicable  owing  to  HafFkine's  prophylactic  being  a  bouillon  culture.  This  last  method  can 
only  be  regarded  as  a  makeshift. 

Gondudivq  remarks. — From  the  point  of  view  of  hygienic  administration,  the  very  mild  cases  of 
plague  are  of  the  utmost  importance.  The  analogy  presented  by  all  other  infectious  diseases 
indicates  that  such  cases  must  be  regarded  as  of  equal  importance  with  the  more  severe  forms  in  the 
possible  dissemination  of  the  disease,  and  constitute,  therefore,  a  grave  source  of  danger  to  the 
community.  It  is  well  known  that  epidemics  of  measles,  scarlet  fever,  and  diphtheria  are  frequently 
preceded  by  a  type  of  the  disease  so  mild  that  many  cases  are  allowed  to  remain  untreated,  and  it  is 
interesting  to  note  that  several  of  the  outbreaks  of  plague  in  the  East  have  been  heralded  by  the 
mildest  possible  form  of  the  disease.  Moreover,  the  difficulties  attendant  on  a  successful  exploratory 
puncture  of  a  small  deep-set  gland  are  sufficiently  obvious,  and  any  other  means  of  arriving  at  a 
definite  conclusion  as  to  the  nature  of  an  obscure  glandular  swelling  is  certainly  entitled  to  the  most 
careful  consideration. 

In  the  severer  forms  of  the  disease  the  possibilities  of  a  serum  diagnosis  are  much  greater.  It 
has  already  been  shown  that  during  the  early  stages  of  the  illness  the  agglutinative  properties  of  the 
blood  are  but  feebly  developed,  and  that  unless  a  careful  technique  be  adopted  for  its  demonstration 
the  reaction  is  liable  to  be  missed  altogether.  After  the  second  week  of  illness,  however,  and 
particularly  in  those  cases  where  the  bubo  undergoes  resolution,  the  chances  of  obtaining  the  bacillus 
by  puncture  of  the  gland  diminish  rapidly  during  convalescence.  This  fact  is  well  illustrated  by  the 
last  three  cases  in  Table  IV. ,  in  which  attempts  to  cultivate  the  organism  by  this  method  at  the  end 
of  the  first,  second,  and  third  weeks  of  illness  respectively  completely  failed,  though  numerous 
degenerated  bacillary  forms  were  seen  in  smear  preparations.  Indeed,  in  the  case  of  Mrs.  M. 
(Table  III.)  culture  tubes  inoculated  on  the  8th  day  of  illness  with  fluid  obtained  from  puncttire  of 
the  bubo  proved  sterile,  though  two  days  previously  an  actively  growing  pure  culture  had  been 
obtained.  On  the  other  hand,  the  agglutinative  power  of  the  serum,  insignificant  at  the  commence- 
ment of  the  illness,  progressively  increases  up  to  the  sixth  or  seventh  week  of  the  disease,  by  which 
time  a  comparatively  high  degree  of  potency  has  been  attained,  especially  in  the  severer  forms  of  the 
disease  which  recover.  Thereafter  it  begins  to  decline,  but,  as  already  shown,  may  be  present  in 
well-marked  cases  four  or  five  months  after  the  primary  illness.  It  is,  therefore,  during  and 
subsequently  to  the  stage  of  convalescence,  when  the  possibility  of  a  bacteriological  diagnosis  is  more 
or  less  remote,  that  the  diagnostic  value  of  the  reaction  becomes  most  apparent.  In  all  cases, 
moreover^  associated  with  the  presence  of  glandular  enlargements  of  dubious  nature,  the  occurrence 
of  which  from  time  to  time  during  the  progress  of  an  epidemic  of  plague  may  present  a  diagnostic 
problem  of  perplexing  character,  the  application  of  this  reaction  cannot  fail  to  prove  of  signal 
service. 


69 


O  o  3 


'  §.2 


P3  M- 


o  f^' — ' 

^  m 
^  m  ' — 'a 

•  -         CO  J 

2  s  § 


^  a  O  I 
S  ■— '   m  - — -  r; 

o  _c  n  o 


»  : 


'    01    M  ,„ 


El  3 
3  q 


.Is 


MSI 


CO 


ca  °     CO  c3 


o  3 
-  o  ^ 


CD    3  M 

M  '3  3 

3  J  a 

c3  01  O 


2 '3  3 


CM 


2 


CD  o 
ft  O 

wot" 


3 

"      a>  «3 

5  >.3^ 


•3    g  §  a 

ft 


.2^S~^ 
3       ft  S  3  3 

S  S  ^< 
ct  o  ^  3  a 


«   -  § 


_  >.  o  2 

c3  ^  to 
^  Q  ft 


-SSiftfi  ° 
CD  „  .ci  w 
ft      2  "  3  . 


3  Si  P 

■-  O 

O  CO  O 

o  3  m  .2 

O-O-^  3  C 

^--j  cc  ^  3 

^  c3  (D  g 

c»   ft  CD  g 

e^s  m  g  a 

^|-3S" 

—  ftjo 


on  3 

CD  — 
ftT" 


CC  o 

3    CD  'o  "~ 

PI       ci  « 

■S  5 'S 

c3  3 

Miosis 

-a  3  § 


ft,3  • 


3 

~  c3 


.2  ^  i 

^  o 

cc  • "  o 

S  CO  O 

cc  O.S' 


a?  ^  O 

01  ■ — '  P-i  CO 


s^^a  3 


0) 


3  c3 
5  O 

r5  — ^  o  CO  a 

o  t>>  O  oj  3 

C^    +=*  a 

pq  a  §  Is 

c3  tJ3~  - 


ft 

CO  o  '-3 


CO  ^ 

ft  a>  " 

cj   d  o 


03 


'  CQ  CO 


bJD 


c3  ^2:; 
o 


^   CD  ^  CD 

..  3   ••  3 

O  ft-^  ft 
^  ~  9  — 
3  ^ 


cc 

03 
CD 

ft' 


(D  CD 

^  r;3  3 

3  t-  " 

cU 

3-S 


g  3 
s-^  ^  a 

..  :3  o  >j  cS 


ft  CD  ^ 

Ul  ^  i-* 

§  "  •• 

..  3  _0 


^ 

_^  o  - 


_g  a  ■ 


S  ftl 


to" 


to  c3  cn  g 

3  3  g 

o  o  ^ 

CD  CO  CD 

o  cX)  y  cy} 

O  O  CD 

ftj 


cu  — 


02 


3  rfl 


3  3^' 


cc  CO  ^  ^  r-i 

r  c3    ^  -p> 

.  O  ft02 

£(M  cS 
1_(  OJ 


O 


•-to  4^ 

^-  ^  ft 

o   CD  -"d 

1«02  2 

P3 


«D  r-3 

cs  a  ^  lo 

^  S  ft02 

^  CD  1) 


™  02  .S  if 


0)  CD 


CD  ^ 

C5 


CD 

bO 


-  ft-^  . 

J.'   S    CD    cu  ^ 

^  S^^cS 


ra     ft  ^    ^    -frj  ^ 


03  CD  a  !5  f/3 

cS  c3 


CD  02  .2 


3 


<S  CXJ   0)  . 

>  CD  a 

cS 


1 


70 


Table  II. — Fatal  Cases. 


Case 
No. 

Name. 

Age. 

Day  of  illness 
on  admission. 

Date  of 
examination  of 
serum,  &c. 

Nature  of  fluid 
examination. 

Amount  of 
serum 
fYersin) 
injected. 

Result  of 
bacterio- 
logical 
examina- 
tion. 

Result  of 
animal 
inocula- 
tion. 

Dilution  of  serum  with 

emulsion  of  bacillus 
pestis  in  proportions  of — 

1  in  10 

1  in  25 

1  in  50 

22. 

Mrs.  M., 

20 

Third  day. 

Third  day. 

Blood,  post  mortem. 

60  CO. 

+ 

+ 

— 

- 

- 

28. 

BabyM., 

7  days 

Seventh  day. 

Blood,  post  mortem. 
Pleural  effusion. 

+ 

+ 

+ 
-1- 

+ 

- 

27. 

Mary  G. , 

6 

Second  day. 

Fourth  day. 
Seventh  day. 

Blood  serum. 
Blood,  post  mortem. 
Pleural  effusion. 

100  CO. 

+ 

+ 
+ 

+  f 

+ 
+ 

+  f 

25. 

Robert  M.,  - 

12 

Third  day. 

Twelfth  day. 

Blood,  post  mortem. 
Pericardial  effusion. 
Peritoneal  effusion. 

80  CO. 

+ 

+ 
+ 
+ 

+ 
+ 

1. 

James  B., 

GO 

Fourteenth  day 

Sixth  week. 

Blood,  poat  mortem. 

+ 

+ 

+  -1- 

+ 

11. 

William  W., 

48 

Fourth  week. 

Sixth  week. 

Blood,  post  mortem. 
Bile,  post  mortem. 

+ 

+ 

-1- 
4- 

+  f 
+  f 

Table  III. — Several  Cases  ending  in  Recovery. 


Case 
N 

Name. 

Age. 

Date  of  illness  on 
admission. 

Date  of  serum 
examination. 

Amount 
of  serum 
(Yersin) 
injected. 

Result  of 
bacterio- 
logical 
examination. 

Result  of 
animal 
inoculation. 

Dilution  of  serum  with  emulsion  of  bacillus 
pestis  in  proportions  of — 

I  in  10 

1  in  25 

1  in  50 

lin  75  [linlOO 

3. 

Pat.  F., 

56 

Second  week. 

Seventh  week. 
Twelfth  week. 

+ 

+ 

+  + 
+  + 

+ 
+ 

+ 

5. 

Mrs.  M.,  - 

40 

Sixth  day. 

Third  week. 

Sixth  week. 
Ninth  week. 
Twelfth  week. 

+ 

+ 

+ 
+  + 
+ 
+ 

+  -1- 
+ 

+  f 

+  + 

+ 

+  f 

o 

Mrs.  T.,  - 

40 

Thirteenth 
day. 

Third  week. 

Eighth  week. 
Tenth  week. 
Twelfth  week. 

+ 

+ 

+  + 

+  + 
-t- 

-1- 

+ 

+ 
+ 
+ 

+  f 

9. 

Thomas  H. , 

15 

Seventh  day. 

Fourth  week. 
Fifth  week. 
Sixth  week. 
Eighth  week. 
Eleventh  week. 
Fifth  month. 

40  c.  c. 

+ 

4- 

+  + 

+ 
+  + 
+  + 
+  + 

+ 

-1-  + 

-t- 

+ 
+  + 
+  + 

-t- 

+ 

+ 
-1- 
+ 

+  f 
+  f 

19. 

Charles  M., 

27 

Second  day. 

Sixteenth  day. 
Fourth  week. 
Sixth  week. 
Eighth  week. 
Four  and  a  half 
months. 

40  c.  c 

+ 

+ 

-1- 

+ 
+  + 
+  + 

+ 

+ 
+ 
+ 
+ 
+ 

+ 
-t- 

+  f 

23. 

Mrs.  M.,  - 

41 

Second  day. 

Seventh  day. 
Eighteenth  day. 
Fifth  week. 

40  c.c 

-1- 

+ 
+ 

-f-f 

+ 

+ 

-1- 

+  f 

X 

Adam  A.,  - 

18 

Second  day. 

Sixtii  day. 
Second  week. 
Sixth  week. 
Ninth  week. 

+  1 

+ 
+ 
+ 

+ 
+ 

+  ? 

1 


71 


Table  IV.— Mild  Cases. 


Case 
No. 

Name. 

Age. 

Day  of  illness  on 
admission. 

Date  of  serum 
examination. 

Amount 
of  seram 
(Yeisin) 
injected. 

Result  of 
bacterio- 
logical 
c  X  tiiTi  1  n  ut'l  oti . 

Result  of 
animal 
inoculation. 

Dilution  of  serum  with  emulsion  of  bacillus 
pestis  in  proportions  of- 

1  in  10 

1  in  25  j  1  in  50 

1  in  75 

1  in  10( 

24. 

Mary  M.,  - 

14 

Second  day. 

Sixth  day. 
Sixteenth  day. 
Third  week. 
Fifth  week. 

40  c.c. 

+ 

+ 
+ 

+  + 

+ 
+ 

+  f 

20. 

Mrs.  B.,  - 

29 

Second  day. 

Ninth  day. 
Eighteenth  day. 
Sixth  week. 

40  c.c. 

+ 

+ 
+  + 

+  f 
+  f 

- 

26. 

Mrs.  (jr., 

28 

Second  day. 

Third  week. 
Fourtli  week. 
Sixtli  week. 
Eii^''hth  week. 
Four  and  a  half 
months. 

+ 

+  + 
+ 
+ 
+ 

+  + 
-J-  + 
+ 

+ 
H — h 
+ 

+ 

- 

4. 

James  C,  - 

24 

Third  week. 

Tliird  week. 
Fifth  week. 
Seventh  week. 
Ninth  week. 

+ 
+ 
+ 
+ 

+  ? 
+ 
+ 
+ 

+  ? 

6. 

Dennis  T.,  - 

6 

Ninth  day. 

Fifth  week. 

+  + 

+  + 

+ 

10. 

RosaM., 

28 

Third  week. 

Fifth  week. 

+ 

+ 

Table  V.— Cases  of  Pestis  Ambulans. 


Case 
No. 


Name. 


Age. 


Day  of  illness  on 
admission. 


Date  of  serum  examina- 
tion. 


Result  of 
tacterio- 
logical 
examination. 


Amount 
of  serum 
(Yersin) 
injected. 


Dilution  of  serum  with  emulsion  of 
bacillus  pestis  in  proportions  of — 


1  in  10 


21. 

Nellie  E., 

17. 

Agnes  R. , 

14. 

Arch.  D., 

8. 

William  M., 

15. 

Jeanie  M., 

13. 

Annie  M'K., 

16. 

Pat.  M'G., 

21 

3i 
18" 

3 
14 
12 
18 


Second  day. 

First  day. 
Seventh  day. 

Fifth  day. 
Second  day. 
Second  day. 
Second  day, 


Third  week. 
Second  week. 
Fourth  week. 
Twentieth  day. 
Second  week. 
Second  week. 
Fovirth  week. 


10  c.c. 


+  f 

H- 

+ 


Table  VI. — Microscopical  Serum  Acglutinations. 
Thomas  H.  (Case  No.  9). 


Date  of  serum 

tion 
10. 

c 

o 

c  o 
3  '■'2 

tion 
75. 

0) 

tion 
100. 

3  ^ 

Il 

tion 
300. 

examination. 

C 

-  .3 

a 

3  g 

£ 

B  c 

s 

=  e 

a 

3  '1 

=  c 

a 

s 

H 

5 

W 

H 

H 

H 

H 

H 

a'Z 

Fifth  week, 

+ 

+ 

5  mins. 

+ 

+ 

ilO  mins. 

+  + 

15  mins. 

+  + 

30  mins. 

+  + 

1  hour. 

+ 

45  mins. 

Eighth  week. 

+ 

+ 

5  mins. 

+ 

+ 

10  mins. 

+  + 

15  mins. 

+  + 

20  mins. 

+  + 

1  hour. 

+ 

1  hour. 

+ 

2  hours. 

Eleventh  week,  - 

+ 

+ 

5  mins. 

+ 

+ 

20  mins. 

+  + 

30  mins. 

45  mins. 

+  f 

1  hour. 

+ 

1  hour. 

+ 

1  hour. 

+  f 

2  hours. 

Four  and  a  half 

months,  - 

+ 

+ 

10  mins. 

+ 

+ 

'30  mins. 

+ 

1  hour. 

+  + 

+  f 

2  hours. 

18  hours. 

Cliarle 

s  iV.  (Case  No.  19 J. 

Fourth  week. 

+ 

+ 

5  mins. 

+ 

+ 

10  mins. 

+ 

1  hour. 

+ 

2  hours. 

+  f 

12  hours. 

18  hours. 

Sixth  week, 

+ 

+ 

5  mins. 

+ 

+ 

10  mins. 

+  + 

45  mins. 

+ 

2  hours. 

+  f 

2  hours. 

+  f 

4  hours. 

Eighth  week. 

+ 

+ 

5  mins. 

+ 

+ 

15  mins. 

+  f 

2  hours. 

Four  and  a  half 

months,  - 

+ 

+ 

20  mins. 

+ 

+ 

30  mins. 

+  f 

2  hours. 

J 


73 


MORBID  ANATOMY  AND  BACTERIOLOGY. 

By  R.  M.  Buchanan,  M.B.  (Glas.),  F.F.P.S.G.,  Bacteriologist  to  the  Corporation. 

The  morbid  anatomy  and  bacteriology  of  plague  as  observed  in  the  outbreak 
in  Glasgow  during  the  autumn  of  1900  are  considered  in  this  Report  under  the 
following  divisions  : — - 

Introductory. 

Details   of  Morbid  Anatomy  as   Recorded  in   Post  -  Mortem 

Reports,  and  Notes  thereanent. 
Microscopical  Examination  of  the  Fresh  Tissues. 
Microscopical  Examination  of  the  Tissues  in  Section. 
Culture  Experiments. 
Inoculation  Experiments. 
Mode  of  Infection. 
Bacteriological  Diagnosis. 

Precautions  Observed  in  Connection  with  Post  -  Mortem 
Examinations  and  Inoculation  Experiments. 

Examination  of  Rats  in  Relation  to  the  Outbreak  of  Plague 
in  Glasgow. 


INTRODUCTORY. 

It  has  been  reckoned  that  at  least  36  persons  were  attacked  during  the  out- 
break, and  that  16  succumbed  to  the  disease.  Of  the  fatal  cases,  7  died  in  their 
own  homes  before  the  disease  declared  itself,  and  were  inferentially  regarded  as 
Plague  from  their  definite  association  with  authentic  cases,  and  9  died  in  Belvidere 
Hospital.  One  of  the  latter  appeared  in  the  Hospital  Returns  as  "  Typhus,"  and 
the  true  nature  of  the  case  was  only  revealed  on  post-mortem  examination.  The 
post-mortem  records  deal  with  seven  cases. 

The  post-mortem  examinations  were  conducted  at  Belvidere  Hospital,  and 
followed  up  by  bacterioscopic  investigation  at  the  Hospital,  and  at  the  Public 
Health  Laboratory.  The  first  examination  was  conducted  by  Professor  Muir,  of 
Glasgow  University,  in  my  absence,  and  the  last  by  Professor  Pertik,  of  Buda-Pesth. 

The  condition  of  the  bodies  as  regards  nutrition  was  notably  good  where  death 
had  occurred  early  in  the  course  of  the  illness,  while  emaciation  was  more  or  less 
evident  in  the  cases  of  longer  duration. 

The  presence  of  petechise  in  the  skin  was  noted  in  two  cases  only.  In  one  of 
these  there  was  also  a  faint  macular  staining  over  the  abdomen  (a  condition  which 
clinically  had  contributed  to  a  provisional  diagnosis  of  typhus).  There  were  no 
gross  hemorrhagic  lesions  visible  in  the  skin,  but  in  about  one-half  of  the  cases 
extravasations  of  blood  were  discovered  in  various  tissues  and  organs. 

In  all  the  bodies  some  swelling  was  evident  either  in  the  groin,  the  arm-pit, 
or  the  neck,  constituting  the  characteristic  bubo. 

The  tendency  of  this  characteristic  lesion  to  occur  with  much  greater  frequency 
in  the  groin  than  in  other  parts  was  shown  by  its  presence  in  this  region  in  four  of 
the  seven  cases.  In  other  two  cases  the  primary  bubo  was  situated  in  the  axilla 
with  a  secondary  bubo  in  the  neck  in  the  one  and  in  the  mediastinum  in  the  other, 
while  in  the  remaining  case  multiple  buboes  appeared  in  both  sides  of  the  neck. 

The  bubo  in  each  instance  was  formed  of  a  group  of  lymphatic  glands  in  a 
setting  of  oedematous,  haemorrhagic,  or  indurated  connective  tissue.  In  four  of  the 
seven  cases  the  bubo  was  in  a  more  or  less  acute  stage,  unaccompanied  by  any  very 
manifest  lesion  in  the  internal  organs ;  in  two  it  was  complicated  with  pneumonia ; 
and  in  the  remaining  one  it  had  reached  a  stage  of  complete  necrosis  and 
sloughing. 


74 


It  will  thus  be  seen  that  the  cases  naturally  grouped  themselves  into  three 
classes  according  to  the  lesions  presented,  namely — 

1.  Acute  bubonic  cases,  without  complication. 

2.  Acute  bubonic  cases,  complicated  with  pneumonia. 

3.  Chronic  bubonic  case,  with  necrosis  and  sloughing. 


DETAILS  OF  MORBID  ANATOMY. 

The  details  of  the  morbid  anatomy  are  fully  recorded  in  the  post-mortem 
reports  appended  to  the  clinical  histories  of  the  fatal  cases,  and  it  is,  therefore, 
unnecessary  to  present  these  reports  again  in  full.  But,  in  order  to  permit  of  a 
collective  view  of  the  cases  from  a  pathological  standpoint,  and  to  facilitate 
reference  to  outstanding  features  in  their  morbid  anatomy,  the  post-mortem  reports 
are  epitomised  and  grouped  together  here  in  the  three  classes  just  mentioned. 
Above  each  epitome  will  be  found  the  case  number,  the  initials  and  age  of  the 
patient,  the  approximate  period  of  incubation,  the  duration  of  illness,  and  the  date 
of  examination. 

I. — Acute  Bubonic  Cases  without  Complication. 

Case  7.— P.M.,  aged  20  Years. 
Approximate  Period  of  Incubation,  3  Days.    Duration  oj  Illness,  5  Days. 
Post-mortem  Examination,  SSth  August,  1900. 
Bubonic  enlargement  of  axillary  and  cervical  glands,  with  periglandular  oedema  and  hsemorrhage. 
Hsemorrhagic  adenitis  with  marked  swelling  of  mediastinal,  prevertebral,  and  inguinal  glands. 
Heart  muscle  paler  than  normal,  but  not  specially  soft.    Hypostatic  congestion  and  some  collapse 
of  the  lungs,  but  no  pneumonia  ;  the  glands  at  the  root  not  visibly  affected.    No  fluid  in  the  pleural 
cavities.    Spleen  enlarged,  weighing  12-^  ounces,  and  softer  than  normal;  splenic  pulp  pale  and 
mottled,  and  nialpighian  bodies  small  but  distinct.     Liver  swollen,  pale,  and  soft,  with  parenchyma- 
tous degeneration  in  a  marked  degree.    Kidneys  swollen  and  soft,  owing  to  cloudy  swelling  of  cortex. 
Pancreas  and  supra-renals  also  swollen  and  soft. 

Bacterioscopic  Examination. — Bacillus  pestis  in  buboes  in  enormous  numbers. 

Case  D. — Mks.  G.,  aged  65  Years. 
Approximate  Period  of  Incubation,  10  Dayn.    Duration  of  Illness,  I4  Daya. 
Post-mortem  Examination,  4th  September,  1900. 
Left  inguinal  bubo  involving  the  transverse  set  of  glands  and  forming  a  sausage-like  swelling 
along  the  line  of  Poupart's  ligament.    The  individual  glands  of  the  bubo  are  about  f  of  an  inch  in 
diameter,  and  appear  as  well-defined  abscesses,  walled  by  a  thin  rind  of  hssmorrhagic  gland  tissue, 
containing  shreds  of  necrosed  tissue  and  brownish  viscid  pus.    Periglandular  tissues  cedematous 
and  densely  matted  together.    Pvight  inguinal  glands  (transverse  set)  hyperffimic  and  enlarged,  one 
being  the  size  of  a  marble,  hssmorrhagic  and  purulent.    Iliac  and  prevertebral  glands  of  left  side 
hypersemic  and  enlarged.    Glands  in  other  parts  appear  normal.    Faint  typhus-like  macular  staining 
of  abdomen.    Petechia  on  abdomen  and  thighs.    Heart  muscle  pale  brown,  soft  and  flabby.  Lungs 
hyperasmic  and  cedematous,  the  right  lower  lobe  showing  some  areas  of  consolidation.    Spleen  soft 
and  dilBuent.    Liver  and  kidneys  manifest  parenchymatous  degeneration. 
Bacterioscopic  Examination. — Bacillus  pestis  not  recovered  from  bubo. 

Case  18. — G.H.,  aged  46  Years. 
Approximate  Period  of  Incubation,  7  Days.  Duration  of  Illness,  10  Days. 
Post-mortem  Examination,  13th  September,  1900. 
Right  inguinal  bubo,  with  periglandular  oedema  and  hoemorrhage.  The  bubo  comprises  the 
vertical  set  of  glands  which  vary  in  size  from  that  of  a  pea  to  a  walnut,  the  distal  gland  being  the 
largest,  and  presenting  a  granular  l)rownish-red  marbled  appearance,  somewliat  resembling  a  mixed 
thrombus  in  transverse  section.  The  retroperitoneal  gland  just  above  Poupart's  ligament  shows  the 
same  hsemorrhagic  enlargement.  The  prevertebral  glands  on  the  right  side  and  the  inguinal  glands 
on  the  left  side  are  slightly  enlarged  and  intensely  hj'perasmic.  Bronchial  glands  enlarged  and 
infiltrated  with  blood.  The  lymphatic  glands  of  the  neck  and  axillae  are  conspicuous  by  their 
red  colour.  The  loose  connective  tissues  in  the  neck  and  in  the  posterior  mediastinum  are  infiltrated 
with  blood.  Subpericardial  ecchymoses  and  some  parenchymatous  degeneration  of  heart  muscle. 
Large  exudation  of  fluid  in  both  pleural  cavities.  Lungs  hyperaBmic  and  cedematous.  Spleen  somewhat 
soft  and  hyperaemic.  Liver  normal  in  size,  but  presenting  cloudy  swelling  in  a  marked  degree. 
Kidneys  large  and  hyperaemic,  and  the  loose  tissues  in  the  hilus  of  each  extensively  infiltrated  with 
blood.  In  the  mucous  membrane  of  the  stomach  and  intestines  numerous  small  punctiform 
haemorrhages  are  found. 

Bacterioscopic  Examination. — Bacillus  pestis  in  bubo  ;  in  prevertebral,  bronchial,  and  left  inguinal 
glands  ;  and  in  blood,  lungs,  spleen,  liver,  and  kidneys.  Pneumococcus  in  bubo,  left  inguinal  gland, 
lungs,  and  kidneys. 

(Figs.  1,  8,  24,  25,  and  26.) 


75 


Case  22. — Mrs.  M,,  aged  20  Yeaes.  ^ 
Approximate  Period  of  Incubation  U7icertain ;  Gasf  in  household  IG  Days  previously. 
Duration  of  Illness,  3  Days. 
Gave  birth  to  Child  in  Hospital  (Baby  M.,  Case  Ho.  28). 
Post-mortem  Examination,  18th  September,  1900. 

Right  inguinal  bubo,  comprising  vertical  set  of  glands  and  retroperitoneal  gland  just  above 
Poupart's  ligament,  with  periglandular  cedema.  The  various  glands  of  the  bubo  are  fully  half  an-inch 
in  diameter,  of  firm  consistence,  intensely  hypersemic  and  finely  mottled.  Prevertebral  glands  on  same 
side  also  notably  affected.  The  lymphatic  glands  generally,  including  those  of  the  mesentery,  are 
slightly  enlarged  and  hyperaemic.  Skin  pale,  and  no  cutaneous  hosmorrhage  evident ;  some  putrefac- 
tive discolouration  of  abdomen.  Heart  firm  in  consistence,  with  subpericardial  ecchymoses  at  apex  of 
left  ventricle,  and  some  cloudy  swelling  of  myocardium.  Hypostatic  congestion  of  the  lungs.  Liver, 
spleen,  and  kidneys  somewhat  hyperjemic.    Uterus  characteristic  of  recent  delivery. 

Bacterioscouic  Examination. — Bacillus  pestis  in  bubo,  blood,  lungs,  liver,  and  spleen.  Pneumo- 
coccus  in  bubo  and  lungs.    Streptococcus  in  lungs. 

(Figs.  9,  10,  11,  and  27.) 

These  cases  formed  a  series  in  which  the  buboes  were  exhibited  in  various 
stages,  from  the  earUer  stage  of  congestion  and  hajmorrhage  to  the  later  one  of 
softening  or  suppuration.  These  stages  corresponded  with  periods  of  illness,  ranging 
from  three  to  fourteen  days.  Periglandular  oedema,  alone  or  with  hsemorrhage,  was 
a  marked  feature  of  the  swelling.  The  appearance  of  the  glands  was  very  remark- 
able. The  somewhat  dry,  granular,  brownish  red,  finely  marbled  or  mottled  cut 
surface,  betokening  congestion,  haemorrhage,  and  necrosis,  was  characteristic,  and 
quite  distinct  from  other  glandular  affections. 

In  each  case,  also,  there  was  considerable  involvement  of  the  neighbouring 
group  of  glands,  and  more  or  less  ]:)olyadenitis,  as  evidenced  by  some  hyperemia 
and  enlargement  of  the  lymphatic  glands  generally. 

The  larger  viscera  presented  no  marked  departure  from  the  normal.  In  the 
heart,  liver,  and  kidneys  there  was  some  cloudy  swelling,  and  the  spleen  was  more 
or  less  soft  and  hypersemic.  Extravasations  of  blood,  apart  from  the  buboes,  were 
found  in  two  of  these  cases  (G.  H.  and  Mrs.  M.).  In  both  there  were  subpericardial 
ecchymoses,  while  in  the  former  there  was  also  extensive  hsemorrhage  in  the  loose 
cervical,  mediastinal,  and  retro-peritoneal  tissues. 

II. — Acute  Bubonic  Cases  complicated  with  Pneumonia. 

Case  28. — Baby  M.,  aged  10  Days. 
Approximate  Period  of  Incubation,  8  Days.     Duration  of  Ilines<,  3  Days. 
Child  of  Mrs.  M.  (Case  No.  22);  born  in  Hospital. 
Post-mortem  Examination,  27th  September,  1900. 

Buboes  on  both  sides  of  neck.  General  enlargement  and  hyperemia  of  axillary,  bronchial, 
mesenteric,  inguinal,  and  prevertebral  lymphatic  glands.  Hemorrhage  and  cedema  of  subcutaneous 
tissue  of  neck.  Marked  parenchymatous  degeneration  of  heart,  liver,  and  kidneys,  and  coagulation 
necrosis  of  right  supra-renal  capsule  Numerous  small  hseniorrhagic  condensations  in  lungs,  many  of 
which  show  a  yellowish  necrotic  centre.  Fibrinous  exudation  on  surface  of  both  lungs.  Opaque 
yellow  fluid  in  pleural  cavities.  Spleen  much  eidarged,  intensely  hyperajmic,  and  of  firm,  liver-like 
consistence.  Liver  enlarged  and  extremely  hyperoemic,  with  very  marked  cloudy  swelling  at  parts  ; 
a  number  of  small  yellow  points  like  tubei'cles  throughout  the  hepatic  tissue.  Kidneys  verv 
hyperEemic,  and  revealing  on  section  minute  hsemorrhagic  foci,  each  with  a  greyish  centre,  situated 
chiefly  in  the  pyramids.  Right  supra-renal  gland  transformed  into  a  dense  yellow,  cheesy-looking 
mass  by  coagulation  necrosis. 

Bacterioscopic  Examination. — Bacillus  pestis  in  buboes,  blond,  lungs,  spleen,  liver,  kidneys,  and 
suprarenals. 

(Figs,  2,  3,  4,  12,  and  IG  to  22.) 

Case  25. — R.M.,  aged  12  Years. 
Approximate  Period  of  Incubation  uncertain  ;  Case  in  household  16  Days  previously. 
Duration  of  Illness,  llf.  Days. 
Post-mortem  Examination,  28th  September,  1900. 

Purulent  axillary  and  subclavicular  buboes.  Surgical  drainage  opening  in  left  mammillary  line 
over  second  intercostal  space,  traversing  the  pectoralis  major  and  minor  towards  the  axilla.  A  mass 
of  purulent  tissue,  consisting  of  enlarged  lymphatic  glands  and  softened  connective  tissue,  extending 


76 


from  axilla  under  pectoralis  minor,  the  glands  being  partly  softened  and  yellowish  grey,  partly  firm 
and  granular,  with  dull  areas  of  coagulation  necrosis.  Pectoralis  minor  and  serratus  anticus  major 
streaked  with  purulent  infiltration.  Abscess  iu  thymus  gland,  and  purulent  infiltration  of  anterior 
mediastinum.  Polyadenitis.  Lobar  and  lobular  pneumonia,  with  numerous  well  defined  reddish-grey 
necrotic  areas  about  the  size  of  a  hazel  nut,  in  both  lungs  ;  fibrinous  exudation  on  both  pleural 
surfaces.  Myocardium  pale  yellowish-brown,  friable,  and  opaque  from  cloudy  swelling.  Spleen 
enlarged,  the  cut  surface  being  smooth,  the  pulp  firm,  and  the  malpighian  bodies  dark  brown.  The 
kidneys  are  of  medium  size,  and  the  cortex  in  each  is  friable  and  opaque.  Liver  of  medium  size,  pale 
yellowish  brown,  and  friable  from  cloudy  swelling.    Punotiform  hfemorrhages  in  stomach. 

Bacierioseopic  Examination. — Bacillus  pestis  in  buboes,  blood,  lungs,  bile,  and  spleen.  Staphy- 
lococcus aureus  in  suppurating  bubo,  in  blood,  lungs,  and  spleen. 

(Figs  5,  6,  and  13.) 

The  presence  of  pneumonia  in  these  two  cases  afforded  the  only  illustrations 
of  involvement  of  the  lungs.  Moreover,  the  conditions  were  very  different  in  each. 
In  Baby  M.,  a  hsemorrhagic  broncho-pneumonia  appeared,  the  consolidations  being 
distinguished  by  a  peripheral  zone  of  haemorrhage,  and  frequently  also  by  a  minute 
yellow  necrotic  centre  of  firm  consistence.  In  the  case  of  R.  M.,  on  the  other  hand,  a 
mixed  croupous  and  lobular  pneumonia  extensively  involved  both  lungs.  Large  and 
well-defined  nodular  necrotic  consolidations  were  disseminated  throughout  the  pul- 
monary tissue.  These  appeared  sharply  defined  in  the  intensely  hyper^mic  and 
cedematous  upper  lobeS;  and  with  less  distinctness,  in  the  midst  of  grey  hepatisa- 
tion,  in  the  lower  lobes  (Figs.  5  and  6).  A  fibrinotxs  exudation  was  manifest  on 
the  pleural  surfaces  in  both  cases. 

The  buboes  in  the  two  cases,  while  displaying  the  same  general  characteristics 
as  those  in  the  first  class  of  cases,  presented  some  points  of  special  interest.  The 
multiple  buboes  on  both  sides  of  the  neck  of  Baby  M.,  involving  the  superficial  and 
deep  cervical  glands,  pointed  to  the  path  of  infection  as  having  been  hy  the  nose 
and  mouth  (most  probably  at  the  time  of  birth),  and  this  view  receives  further 
support  in  the  presence  of  the  broncho-pneumonia.  The  purulent  infiltration  of 
the  tissues  in  the  neighbourhood  of  the  buboes  in  the  case  of  R.  M.  had  resulted 
from  mixed  infection  with  staphylococcus,  pyogenes  aureus. 

As  regards  the  condition  of  the  other  internal  organs  of  these  two  cases,  the 
most  notable  change  was  the  pronounced  cloudy  swelling,  especially  of  the  heart. 
In  the  right  suprarenal  capsule  of  Baby  M.,this  degenerative  change  had  ultimated 
in  coagulation  necrosis.  The  multiple  metastatic  foci  in  the  liver  and  kidneys  were 
also  a  remarkable  manifestation  of  the  moi'bid  process  in  this  case  (Figs.  3  and  4)., 
Similar  foci  were  also  observed  in  one  other  case  namely,  (J.B.  No.  1.),  but  only  in 
the  kidneys.  A  similar  condition  was  found  in  the  liver  of  a  mouse  which  died 
on  the  sixth  day  after  experimental  inoculation. 

Professor  Zabolotny,  of  St.  Petersburg,  who  was  present  at  most  of  the  post- 
mortem examinations,  and  whose  kindness  and  assistance  during  the  epidemic  I 
have  the  greatest  pleasure  in  acknowledging,  informed  me  that  he  had  frequently 
observed  these  foci  in  the  course  of  his  work  in  connection  with  plague  in  various 
countries. 


III. — Chronic  Bubonic  Case,  with  Necrosis  and  Sloughing. 

Case  1. — J.B.,  aged  60  Years. 
Approximate  Period  of  Incubation,  9  Days.     Duration  of  Illness,  J/S  Days. 
Post-mortem  Examination,  SSth  September,  1900. 

Right  inguinal  bubo,  with  indolent  sloughing  ulcer  in  skin.  Under  floor  of  ulcer  a  dense  mass  of 
soft  granular  yellowish  necrotic  substance,  like  inspissated  pus,  extending  upwards  in  the  course  of 
the  vessels  under  Poupart's  ligament,  and  continuous  with  a  chain  of  partitioned  abscesses  partly 
filling  the  right  iliac  fossa,  the  right  side  of  the  pelvis,  and  impinging  on  the  right  wall  of  the  bladder. 
Purulent  infiltration  of  psoas  muscle  upwards  to  lumbar  vertebras.  A  sinus  leads  from  the  lower  of 
these  abscesses  downwards  to  discharge  from  a  small  opening  in  upper  end  of  ulcer.  Purulent 


77 


infiltration  of  the  subcutaneous  and  deeper  tissues  half-way  down  the  thigh.  -^Glands  in  other  regions 
appear  normal.  Lungs  hyperasmic  and  oedematous.  Heart  muscle  pale  and  cloudy;  fibrous 
thickening  of  aortic  and  mitral  curtains.  Liver  hyperjemic.  Spleen  enlarged  and  of  firm  consistence. 
In  both  kidneys  there  are  numerous  small  yellow  points  like  tubercles  visible  in  the  cortex,  A  small 
ulcer  appears  in  the  gastric  mucous  membrane  near  the  pylorus. 

BaaerioKConic  Examination. — Bacillus  pestis  not  recovered  from  bubo  or  organs.  Colonies  of 
staphylococcus  in  periphery  of  glands  of  bubo. 

(Fig.  7.) 

This  case  is  of  special  interest,  in  contrast  with  those  already  described,  on 
account  of  the  long  duration  of  illness,  and  the  consequent  modification  of  the  bubo. 
The  whole  of  the  bubonic  tissue  had  undergone  necrosis  and  was  in  process  of 
sloughing,  while  a  number  of  large  abscesses  followed  the  course  of  the  vessels 
upwards  into  the  pelvis.  Extensive  purulent  infiltration  also  involved  the  sub- 
cutaneous and  intermuscular  tissues  of  the  thigh. 

With  the  exception  of  the  kidneys,  the  internal  organs  presented  no  features 
calling  for  special  reference.  The  small  yellow  foci  observed  in  the  kidneys  have 
already  been  referred  to  in  connection  with  the  case  Baby  M.  They  resembled 
somewhat  metastatic  abscesses,  but  were  of  firm  consistence,  and  unaccompanied 
by  any  evidence  of  inflammation. 


MICROSCOPICAL  EXAMINATION  OF  THE  FRESH  TISSUES. 

Preparations  were  made  at  the  time  of  the  post-mortem  examination  from  the 
glandular  swellings.  This  was  done  by  drawing  the  edge  of  a  cover  glass,  charged 
with  material  from  the  cut  surface  of  the  gland,  lightly  across  the  slide,  so  as  to 
make  a  thin  uniform  film.  A  series  of  film  specimens  was  in  like  manner  secured 
from  the  blood  and  organs  generally.  The  films  were  fixed  with  absolute  alcohol, 
and  stained  for  about  five  minutes  with  carbol-thionin-blue,  or  for  as  many  seconds 
with  carbol-fuchsin.  Gram's  method  proved  of  great  value  as  a  control  stain,  inas- 
much as  the  bacillus  pestis  characteristically  failed  to  hold  the  stain  by  this  method, 
while  other  species,  such  as  pneumococcus,  staphylococcus,  and  streptococcus,  if 
present,  were  rendered  prominent  by  retaining  it. 

In  those  preparations  from  buboes  in  the  acute  stage  bacillus  pestis  was  found 
in  great  number,  and  in  .what  might  be  called  its  typical  vegetative  or  normal 
form — namely,  a  short  thick  bacillus  with  rounded  ends,  the  ends  staining  deeply 
in  contrast  with  the  faintly  stained  or  colourless  centre,  and  producing  the  picture 
known  as  "  polar  staining  "  (Plate  II.).  The  bacilli  were  generally  evenly  dis- 
tributed throughout  a  thin  film  as  isolated  elements,  while  in  the  thicker  films 
they  were  often  found  heaped  together  in  very  great  numbers. 

In  preparations  from  lesions  of  longer  duration  the  bacilli  showed  a  degenerative 
tendency,  losing  the  plump  appearance,  and  becoming  irregular  in  size,  stunted  or 
elongated,  ovoid,  and  finely  globular  (Fig.  9).  The  degree  of  staining  at  the  same 
time  appeared  less  and  less,  until  there  was  only  a  thin  crescent  at  the  position  of 
the  polar  protoplasm,  or  a  faint  marginal  rim  all  round.  Finally,  bloated, 
colourless  forms  could  be  seen,  by  intense  staining  of  the  specimen,  forming  great 
areas,  in  which  a  comparatively  small  number  of  more  recent  forms  were  scattered. 
An  erroneous  impression  of  the  number  of  bacilli  might  thus  at  first  sight  be 
obtained. 

A  mixed  infection  was  very  apparent  in  the  films  made  from  two  cases  (G.  H. 
and  Mrs.  M.),  in  which  the  bacillus  pestis  was  found  in  association  with  the 
pneumococcus.  Figs.  9  and  10  show  this  mixed  infection  in  the  lung  and  bubo  of 
one  of  these  cases. 

Considerable  interest  attaches  to  the  case  in  which  the  stage  of  suppuration  ot 
the  bubo  had  been  reached  (Case  D,  Mrs.  G.).  Here  no  trace  of  the  plague 
bacillary  forms  could  be  obtained  under  the  microscope,  although  there  were 


78 


numerous  round  bodies  and  tadpole-like  forms,  which  might  be  regarded  as 
involution  forms  of  bacillus  pestis,  from  the  close  resemblance  to  similar  forms 
obtained  in  artificial  cultures,  especially  on  gelatine.  The  duration  of  this  case  was 
about  14  days,  and  the  entire  disappearance  of  the  plague  bacillus  from  the  body 
within  this  period  is  noteworthy. 

In  the  case  of  J.  B.  (No.  1)  it  is  not  surprising  that  the  bacillus  pestis  was  not 
obtained  from  the  bubo,  considering  that  the  patient  lived  for  fully  six  weeks. 
The  same  evidence  of  the  presence  of  degenerated  forms  was  manifest  however,  and 
the  transition  from  the  bacillary  to  the  distorted  form  was  quite  traceable. 


MICROSCOPICAL  EXAMINATION  OF  THE  TISSUES  IN  SECTION. 

Sections  for  microscopical  examination  were  made  from  specimens  of  the 
organs  and  tissues  of  each  case. 

The  tissues  were  fixed  and  hardened  in  absolute  alcohol,  and  sections  were 
obtained  by  embedding  in  paraffin,  according  to  the  following  method : — Selected 
pieces  were  immersed  for  a  few  hours  in  fresh  absolute  alcohol,  and  then  transferred 
to  cedar  oil  overnight,  the  bottle  containing  the  oil  being  placed  on  the  top  of  the 
paraffin  bath.  Next  morning  the  pieces  were  placed  in  soft  paraffin  (45°  C),  after 
being  freed  of  superfluous  cedar  oil  by  means  of  filter  paper,  and  kept  in  the  bath 
for  about  three  hours  at  a  temperature  of  53°  C.  The  pieces  were  then  transferred 
to  hard  paraffin  (52°  C.)  for  about  two  hours,  and  finally  embedded  in  fresh  hard 
paraffin. 

The  staining  of  the  bacillus  pestis  in  situ  in  the  various  organs  and  tissues 
was  frequently  difficult  to  accomplish  satisfactorily,  on  account  of  its  feeble  hold  on 
stains  in  the  presence  of  decolourising  agents.  Various  methods  were  tried,  and 
the  following,  in  which  carbol-thionin-blue  and  eosin  were  used  as  stain  and 
counterstain,  was  the  one  which  gave  the  best  results : — The  sections  were  (1) 
stained  on  the  slide  for  five  minutes  with  carbol-thionin-blue,  rinsed  in  water  to 
get  rid  of  excess  of  the  stain,  differentiated  in  water  to  which  a  few  drops  of  acetic 
acid  had  been  added,  and  washed  in  water ;  (2)  counterstained  with  J  per  cent, 
watery  solution  of  eosin  for  30  seconds,  washed  in  water,  dehydrated  in  absolute 
alcohol,  cleared  in  xylol,  and  mounted  in  Canada  balsam. 

The  Bubo. 

In  the  earlier  stages  of  the  glandular  swelling  the  periglandular  blood  vessels 
are  found  to  be  greatly  engorged  (Fig.  24).  Extravasations  of  blood  are  also 
numerous  and  extensive  in  the  investing  tissues  of  the  glands.  Thrombosis  of  the 
periglandular  vessels  appears  in  the  bubo  of  one  of  the  cases  (Mrs.  M.,  No.  22). 

The  affected  glands  exhibit  various  conditions,  depending  apparently  on  the 
duration  and  intensity  of  the  morbid  process — namely,  (a)  bacillary  invasion  of  the 
periphery  of  the  gland  only ;  (h )  bacillary  invasion  of  the  entire  gland,  with  great 
congestion  and  haemorrhage  ]  (c)  bacillary  invasion  and  necrosis  of  the  gland  along 
certain  tracks;  (cl)  bacillary  invasion  and  necrosis  of  the  whole  gland;  and  (e) 
softening  or  suppuration,  with  entire  disappearance  of  the  bacilli. 

(a)  Bacillary  invasion  of  the  periphery  of  the  gland  only. — In  several 
instances  it  is  found  that  bacillus  pestis  has  become  aggregated  in  great  masses 
in  the  periphery  of  the  lymphatic  glands,  in  what  appears  to  have  been  a  very 
early  stage  in  the  formation  of  the  bubo.  In  other  respects  the  glands  a2Dpear 
fairly  normal  (Fig.  16).  This  tendency  of  the  bacillus  pestis  to  accumulate  in 
enormous  numbers  in  the  periphery  of  the  gland  is  also  seen  in  the  bubo  of  a 
plague-infected  mouse. 


79 


(b)  Bacillary  invasion  of  the  entire  gland,  ivith  great  congestion  and 
hcemorrhage. — In  the  more  acute  buboes  congestion  and  haBmorrhage  are  the 
outstanding  features.  A  great  engorgement  of  the  blood  vessels  and  a  general 
extravasation  of  blood — not  uniformly,  but  in  homogeneous  areas  and  infiltrations 
— are  visible  throughout  the  gland.  The  gland  tissue,  as  such,  has  almost 
entirely  disappeared,  and  the  section  is  more  like  that  of  a  spongy  vascular 
tissue.  Extending  throughout  the  gland  are  also  homogeneous  masses  and  tracts 
of  plague  bacilli.  Their  number  is  so  great  and  their  aggregation  so  close  that 
they  completely  obliterate  all  trace  of  gland  structure.  In  the  upper  pai-t,  and  to 
the  right  of  Fig.  24,  such  a  mass  of  bacilli  is  shown  in  the  periphery  of  a  bronchial 
gland,  the  lighter  parts  in  the  dark  mass  being  due  to  extra vasated  blood.  The 
enormous  numbers  in  which  these  bacilli  pervade  the  affected  tissues  cannot  but 
be  regarded  ctS  9j  special  feature  of  the  disease. 

(c)  Bacillary  invasion  and  necrosis  of  the  gland  cdong  certain  tracts. — 
Taking  a  gland  which  appears  to  the  naked  eye  as  only  slightly  affected,  a 
condition  differing  very  materially  from  that  just  described  is  found.  Although 
the  vessels  are  engorged,  there  is  comparatively  little  or  no  haemorrhage. 
Certain  tracts  of  gland  tissue  invaded  by  plague  bacilli  have  undergone  necrosis. 
The  cellular  necrosis  exhibited  in  these  tracts  is  a  very  striking  feature.  It  is 
seen  in  the  various  stages  which  mark  coagulation  necrosis — namely,  swelling  with 
fine  granulation  of  the  cell  protoplasm,  disappearance  of  the  nucleus,  and,  finally, 
disappearance  of  the  cell  outline.  It  is  notable  that  this  necrosis  appears  to 
have  involved  the  bacilli  themselves  in  like  manner,  for  where  it  is  most  advanced 
the  bacilli  have  also  become  indistinct,  and  refuse  to  take  the  stain.  The  other 
parts  of  the  gland  lying  between  these  necrotic  tracts  are  normal  in  appearance, 
and  free  from  bacillary  invasion  (Fig.  25). 

(d)  Bacillary  invasion,  and  more  or  less  complete  necrosis  of  the  whole 
gland  tissue. — This  condition  is  evidenced  to  the  naked  eye  by  a  greyish  or 
yellowish-grey  appearance  of  parts  of  the  gland  or  of  the  whole  gland,  or,  when 
much  hasmorrhage  is  also  present,  by  a  mottled  brownish  red  and  grey.  The 
tissues  of  the  gland  have  lost  much  of  their  outline,  appearing  more  or  less 
homogeneous,  and  devoid  of  nuclear  staining.  The  bacilli  have  almost  disappeared, 
and  can  only  be  seen  in  faintest  outline.  In  marginal  parts  of  the  gland, 
however,  they  are  still  to  be  found  in  distinct  and  characteristic  swarms.  The 
walls  of  the  blood  vessels,  in  one  case  (Mrs.  M.),  are  homogeneous,  swollen  and  con- 
voluted, and  the  larger  vessels  in  many  instances  are  filled  with  leucocytes.  A 
number  of  leucocytes  also  remain  distinct  throughout  the  dead  tissue  (Fig.  27). 
As  all  these  conditions  could  be  found  in  a  case  in  which  the  illness  was  only  of 
three  days'  duration,  the  entire  disappearance  of  the  bacillus  pestis  from  the  bubo 
would  presumably  be  a  matter  of  a  few  days  more.  In  this  tendency  to  early 
extinction  of  the  bacillus  pestis  in  a  bubo  rests  the  explanation  of  the  negative 
results  sometimes  obtained  after  exploratory  puncture  for  purposes  of  diagnosis, 
even  in  the  end  of  the  first  week  (see  Dr.  M'Clure's  Report  on  Clinical  Bacteriology 
page  57),  and  also  of  the  diminution  or  complete  loss  of  infectivity  which,  as  a  rule, 
distinguishes  the  discharge  from  a  plague  bubo. 

(e)  Softening  or  suppuration,  with  entire  disapjyearcmce  of  the  bacilli. — In 
the  case  of  Mrs.  G.  (Case  D)  the  glands  of  the  bubo  had  all  undergone  softening, 
and  resembled  so  many  well-defined  abscesses  containing  brownish  viscid  pus. 
Sections  from  a  less  affected  gland  from  the  other  groin  show  no  trace  of  plague 
bacilli ;  but  a  considerable  number  of  round  bodies,  varying  greatly  in  size,  are 
readily  detected.  The  large  number  of  these  bodies,  and  their  resemblance  to 
similar  bodies  in  old  cultures,  especially  old  gelatine  cultures,  of  bacillus  pestis, 
indicate  that  they  are  bacilli  which  have  undergone  modification  into  the 
characteristic  "  involution  "  form.  Again,  in  the  case  of  J.  B.  (Case  No.  1),  in  which 
some  of  the  glands  were  soft  and  yellow,  like  inspissated  pus,  and  others  were  in 
the  form  of  large  abscesses  (Fig.  7),  the  same  bodies  are  found  in  even  greater 
number. 


80 


Lungs. 

The  two  cases  of  secondary  pneumonia  present  very  different  conditions  under 
the  microscope.  In  the  case  of  Baby  M.  numerous  small  foci  of  condensation  are 
visible  to  the  naked  eye  throughout  the  section.  Under  the  microscope  these  are 
found  to  be  due  to  the  occupation  of  groups  of  lung  alveoli  by  colonies  of  plague 
bacilli;  the  appearance  presented  bearing  a  remarkable  resemblance  to  an  artificial 
coloured  injection  of  the  air  spaces  (Fig.  17).  Each  group  of  invaded  alveoli  marks 
the  distribution  of  a  bronchiole.  The  central  part  of  the  invaded  area  is  necrosed, 
and  in  the  peripheral  part  the  alveoli  are  occupied  by  blood  corpuscles.  Very  few 
leucocytes  are  present.  The  pulmonary  vessels  generally  are  engorged  with  blood, 
and  the  perivascular  lymph  channels  and  those  of  the  pleura  are  occupied  by 
enormous  numbers  of  plague  bacilli  (Fig.  18).  In  the  case  R  M.  the  conditions 
presented  are  those  of  croupous  pneumonia.  The  lung  alveoli  are  occupied  by  a 
network  of  fibrin,  and  notably  few  cell  elements  are  present.  Plague  bacilli  are 
scattered  diffusely  throughout  the  alveoli  in  great  number.  In  the  necrotic  areas 
the  same  general  appearances  are  found,  but  with  the  additional  evidence  of 
coagulation  necrosis. 

Liver. 

The  liver  in  the  case  of  Baby  M.  shows  focal  accumulations  of  bacillus  pestis 
in  the  capillary  vessels.  On  surveying  the  section  under  the  low  power,  it  is  found 
that  these  colonies  or  foci  are  very  numerous,  and  are  distributed  almost  uniformly 
throughout  the  organ.  In  and  around  them  is  a  small  number  of  leucocytes  (Figs. 
21  and  22).  The  capillaries  generally  are  greatly  distended,  and  show  compara- 
tively few  bacilli.  The  yellow  foci  mentioned  in  the  post-mortem  report,  and 
shown  in  Fig.  4,  are  essentially  of  the  same  structure,  being  composed  simply  of  a 
proportionately  greater  number  of  bacilli  and  leucocytes.  Necrosis  of  the  hepatic 
cells  in  the  vicinity  of  the  nodules  is  not  seen,  and  the  hepatic  cells  actually 
involved  in  the  lesion  have  disappeared,  apparently  as  the  result  of  pressure.  Fig. 
23  shows  the  liver  of  a  plague-infected  mouse  which  died  on  the  sixth  day,  and  in 
which  a  similar  condition  is  observed.  Here,  however,  the  plague  bacilli  have 
disappeared.  Only  a  few  are  to  be  found  in  the  part  which  is  attached  to  the 
ruptured  vessel  wall. 

Spleen. 

The  microscopical  examination  of  the  spleen  reveals  the  bacillus  pestis 
uniformly  distributed  in  great  numbers  throughout  the  capillaries  in  the  cases 
of  G.  H.  and  Mrs.  M.,  but  extremely  scanty  in  the  cases  of  Baby  M.  and  R.  M. 
A  notable  contrast  is  afforded  by  the  spleen  and  the  bubo,  in  the  absence  of 
coagulation  necrosis  in  the  spleen,  although  the  accumulation  of  pest  bacilli  may 
be  very  great.  In  Fig.  26  the  distribution  of  bacillus  pestis  throughout  the  splenic 
tissue  is  shown,  but  only  a  comparatively  small  number  of  the  bacilli  are  in  focus. 

Kidney. 

An  interesting  condition  is  exhibited  in  the  kidney  of  G.  H.  Bacillus  pestis 
is  seen  throughout  the  organ  adhering  closely  to  the  intima  of  the  capillaries,  and 
apparently  passing  through  their  walls  into  the  perivascular  tissue,  in  which 
considerable  accumulations  of  the  bacilli  frequently  appear.  Capillary  vessels  are 
here  and  there  obstructed  by  small  groups  of  bacilli.  Careful  search  fails  to  reveal 
the  presence  of  a  single  bacillus  within  the  renal  tubules. 

In  Fig.  19  a  localised  growth  of  bacillus  pestis  is  shown  in  the  kidney  of 
Baby  M.,  and  represents  one  of  the  "  foci  "  observed  post-mortem.  The  bacilli  are 
aggregated  in  great  masses  between  the  tubules  within  a  certain  area,  and  are 
associated  with  a  considerable  amount  of  leucocyte  infiltration  of  the  part. 


81 

In  the  case  of  J.  B.  the  yellow  foci  appear  in  small,  well-defined  subcapsular 
areas  in  which  tubular  structure  is  to  some  extent  retained.  The  tubules  are, 
however,  distorted  and  distended,  and  a  semblance  to  papilliform  structure  is 
noticed  here  and  there.  They  mostly  show  a  lining  of  proliferating  epithelium, 
and  many  of  the  cells  have  been  shed  singly  and  in  casts.  A  few  spaces  are 
occupied  bv  granular  contents  composed  of  degenerated  epithelium  and  red  blood 
corpuscles.  No  trace  of  B.  pestis  or  other  organism  is  found.  The  interstitial 
tissue  of  the  kidney  is  increased,  and  shows  a  large  amount  of  round  cell  infiltra- 
tion.   Many  of  the  glomeruli  have  undergone  fibroid  change. 

Suprarenal  Gland. 

The  microscopical  examination  of  the  necrosed  suprarenal  found  in  the  case  of 
Baby  M.  shows  the  same  focal  developments  of  bacillus  pestis  as  pertains  in  the 
other  organs  of  this  case  (Fig.  20).  Only  a  thin  rind  of  gland  tissue  just  under  the 
fibrous  capsule  appears  normal,  the  great  mass  of  the  parenchyma  having  under- 
gone coagulation  necrosis.  In  the  suprarenal  of  G.  H.  the  bacillus  pestis  is 
uniformly  and  sparsely  distributed  in  the  blood  vessels,  but  otherwise  the  gland 
appears  normal. 


CULTURE  EXPERIMENTS. 

Cultures  were  obtained  by  the  inoculation  of  agar  at  the  time  of  the  'post- 
mortem examination.  Material  from  the  bubo,  the  blood,  and  the  viscera  generally 
waG  taken  by  means  of  a  Pasteur  pipette,  and  immediately  implanted  on  agar 
surfaces  in  test  tubes  or  m  plates.  The  latter  had  the  comparative  advantage  that 
they  afforded  a  larger  surface  for  the  spread  of  the  infective  material,  and  also 
that  the  growth  could  be  more  readily  examined  under  the  microscope.  It  also 
permitted  of  easy  separation  of  the  species  in  the  cases  of  mixed  infection. 

No  growth  became  visible  in  the  medium  until  the  second  day.  A  crop  of 
minute  greyish  colonies  then  appeared.  On  closer  inspection  with  a  lens,  and  by 
transmitted  light,  these  showed  a  greyish  white  centre  and  a  translucent  uneven 
margin.  Under  a  low  power  an  average  colony  looked  finely  granular,  with  an 
opaque  brown  centre,  a  broad  translucent  marginal  zone,  and  a  very  irregularly 
indented  edge.  With  the  high  power  the  smallest  colonies  were  very  ti'anslucent 
thin  films,  slightly  more  dense  in  the  centre,  and  marked  all  over  by  a  veiy  fine 
mosaic  pattern ;  while  larger  colonies  had  the  same  general  appearance  as  under 
the  low  power.  The  features  thus  exhibited  in  the  smallest  colonies  were  remark- 
ably characteristic. 

After  this  earliest  appearance  the  growth  gradually  became  more  and  more 
pronounced,  and  attained  a  maximum  in  about  ten  days.  With  increase  in  size  the 
colonies  became  white  and  opaque  in  the  centre,  and,  when  numerous  and  closely 
set,  produced  an  opaque  finely  granular  surface,  which  has  been  well  likened  to  the 
appearance  of  a  bit  of  ground  glass  (Fig.  28).  At  the  same  time  numerous  colonies 
of  larger  size  appeared  here  and  there,  dense,  glistening,  waxy  white  with  reflected 
light,  and  brownish  yellow  with  transmitted  light.  These  large  or  "  giant  colonies  " 
when  sufiiciently  isolated  showed  very  characteristic  outlines,  namely,  a  raised 
yellowish  dome-like  centre  and  a  clear  crenated  border. 

In  cultures  in  which  the  colonies  were  well  isolated  from  one  another,  each 
colony  attained  a  size  of  1  to  4  mm.,  and  presented  the  same  general  characteristics 
as  the  giant  colonies,  but  with  the  border  exaggerated  and  characteristically  crimped 
or  knobbed.  This  appearance,  which  might  be  regarded  as  the  impress  of  full 
development,  persisted  afterwards  as  the  distinguishing  feature  of  the  growth,  even 
after  it  had  become  dried. 

Another  very  marked  characteristic  of  the  growths  was  their  viscidity,  which 
manifested  itself  on  attempting  to  remove  colonies,  especially  when  confluent,  by 
means  of  the  platinum  wire. 


82 


The  microscopic  appearances  of  the  bacillus  in  cultures  were  as  follows : — 
When  an  agar  culture  was  examined  between  24  and  48  hours,  the  colonies  yielded  a 
small  squat  bacillus,^  only  slightly  longer  than  broad, and  rounded  in  the  ends  (Fig.  30). 
In  some  cultures  longer  forms  were  met  with,  and  so  irregular  were  the  elements 
in  this  respect  as  to  suggest  a  mixed  growth.  In  these  latter  cultures  the  longer 
bacilli  were  often  slightly  curved  and  clubbed,  resembling  in  outline  somewhat  the 
the  bacillus  diphtheriEe,  with  one  of  the  ends  often  squared  or  fractured  looking. 
This  square-cut  end  was  often  exhibited  in  specimens  from  the  fresh  tissues,  and 
appeared  to  mark  recent  division  through  the  clear  centre  of  the  parent  bacillus. 

In  older  agar  cultures  the  polymorphism  of  the  bacillus  was  further  and  still 
more  remarkably  exhibited  by  so-called  "  involution  forms."  A  certain  minority  of 
the  bacilli  was  seen  to  have  become  greatly  enlarged,  and  capable  of  intense 
staining.  In  this  enlargement  they  retained  the  bacillary  form,  or  assumed  a 
globular,  piriform,  or  knobbed  shape  (Fig.  33).  Forms  like  fragments  of  mycelial 
threads  were  also  frequently  seen.  In  the  midst  of  these  grotesque  forms  the  great 
majority  of  the  bacilli  could  still  be  seen  in  faint  outline  degenerated  and  unstained- 
These  "  involution  forms  "  were  obtained  from  an  ordinary  agar  culture  at  the  end 
of  six  weeks.  They  were  not,  however,  uniformly  so  obtainable  in  the  cultures  from 
all  the  cases.  In  many  old  cultures  on  ordinary  agar,  it  was  commoner  to  find  this 
involutionary  change  much  less  pronounced,  as  shown  on  Fig.  34;  the  modification 
of  form  not  being  so  extreme,  and  the  number  of  elements  undergoing  involution 
not  so  great. 

Solidified  blood  serum  yielded  an  abundant  yellowish-white  glistening  growth 
in  well  marked  colonies,  or  in  ridges,  having  the  same  general  outline  as  the 
growth  on  agar,  namely,  a  raised  centre  sloping  to  a  flattened,  crimped,  or  crenated 
border. 

On  gelatine  very  copious  growths  were  obtained.  The  colonies  also  closely 
resembled  those  on  agar,  but  were  whiter,  being  silvery  grey  with  transmitted 
light,  and  faintly  grey  or  dewdrop-like  with  reflected  light.  There  was  nothing 
specially  notable  in  stab  cultures,  except  the  tendency  to  frond-like  expansions  on 
the  surface  of  the  gelatine.    No  liquefaction  took  place. 

On  serum  and  on  gelatine  the  bacillus  presented  the  same  morphological 
characters  as  on  agar.  It  was  observed  that  the  involution  forms  on  serum  were 
mostly  elongated,  while  those  on  gelatine  were  mostly  globular  and  extremely 
varied  in  size. 

In  ordinary  bouillon  sub-cultures  were  made  as  control  experiments.  It  was 
found  that  the  bacillus  isolated  from  each  case  gave  a  characteristic  growth  of 
chain  forms.  The  growth  appeared  as  a  creamy-white  deposit  in  a  clear  medium. 
Sometimes  it  also  formed  a  fine  whitish  dusting  on  the  sides  of  the  tubes,  and 
sometimes  the  fluid  was  at  first  rendered  turbid,  to  become  ultimately  clear 
however.  This  tendency  to  cause  turbidity  of  the  medium  seemed  to  belong  to 
certain  cultures. 

The  chains  of  bacilli  obtained  from  these  cultures  were  composed  of  four  to  six 
elements  as  a  rule,  and  are  shown  in  Fig.  31  as  they  appeared  at  the  end  of  forty- 
eight  hours.  When  the  same  culture  was  examined  at  the  end  of  four  days,  the 
individual  elements  forming  the  chains  had  become  rounded  and  swollen,  and  many 
of  them  degenerated  so  that  they  would  not  stain,  as  may  be  seen  in  Fig.  32. 


INOCULATION  EXPERIMENTS. 

Inoculation  experiments  were  undertaken  only  for  the  purpose  of  diagnosis, 
and  reference  may  be  made  to  several  which  were  attended  by  results  of  exceptional 
nature. 


^  The  bacillus  was  readily  stained  by  ordinary  aniline  dyes,  and  as  readily  decolourised  by  the 
Gram  method. 


83 


The  animals  used  were  mice.  Two  of  these  animals  were  inoculated  from  the 
bubo  of  G.  H.  (Case  No.  18),  in  which  there  was  a  mixed  infection.  Mouse  I.,  inocu- 
lated subcutaneously,  died  in  36  hours  Avithout  glandular  enlargement,  and  only  the 
pneumococcus  was  found  under  the  microscope,  and  in  cultures  from  the  blood  and 
spleen.  Mouse  II.  had  the  infected  material  applied  to  the  nostrils,  and  died  in  48 
hours  with  typical  lesions  of  plague  in  the  lungs  and  lymphatic  glands,  the  bacillus 
being  obtained  in  pure  culture.  The  value  of  this  method  of  inoculation,  as  a 
control  experiment,  was  thus  corroborated. 

Material  from  the  case  of  R.  M.  (No.  25)  produced  results  of  exceptional 
interest.  Mouse  VII.  was  inoculated  subcutaneously  from  the  axillary  bubo  (which 
was  much  necrosed)  and  survived  six  days — the  inguinal  and  axillary  glands  appear- 
ing as  yellowish-white  bubonic  swellings,  and  the  liver  being  studded  throughout 
with  minute  yellow  foci.  Only  a  few  bacilli  were  found  in  the  blood.  The  first 
sub-culture  from  the  same  bubo  proved  fatal  to  Mouse  XIV.  in  three  days.  On  the 
other  hand.  Mouse  VIII.,  inoculated  from  the  pneumonic  lung  of  this  case,  lived  for  27 
days.  After  ten  days,  nervous  symptoms  appeared  in  the  form  of  twitchings  of  the 
head  backwards,  some  paralysis  of  the  hind  legs,  and  a  tendency  on  the  part  of  the 
animal  to  go  round  and  round,  as  if  chasing  its  tail.  Those  symptoms  were  present 
for  about  a  fortnight,  but  were  only  very  marked  when  the  animal  was  disturbed, 
and  were  gradually  disappearing  up  to  the  time  of  death.  No  lesions  were  found 
on  post-mortem  examination,  and  no  bacilli  developed  in  cultures. 

Mouse  XII.,  inoculated  subcutaneously  from  the  retroperitoneal  bubo  of  Mrs.  M. 
(Case  No.  22),  died  in  two  days. 

Mouse  XIII.,  inoculated  from  the  second  suh-culture  obtained  from  the 
cervical  bubo  of  Baby  M.  (Case  No.  28),  lived  for  15  days. 

A  marked  contrast  with  the  latter  experiment  was  seen  in  Mouse  XL,  which 
succumbed  in  three  days  after  subcutaneous  inoculation  with  the  third  siih-cidture 
from  the  bubo  of  G.  H. 

These  few  experiments  serve  to  illustrate  a  remarkable  variation  in  the  degree 
of  virulence  of  the  virus  under  the  different  conditions  presented. 


MODE  OF  INFECTION. 

The  study  of  the  macroscopic  and  microscopic  appearances  in  these  seven 
cases  does  not  permit  of  the  expression  of  a  definite  opinion  as  to  the  mode  of 
infection  or  the  path  of  entrance  of  the  plague  bacillus  into  the  body.  At  the 
same  time  certain  considerations  have  been  noted  as  bearing  on  this  important 
question,  and  demand  a  passing  reference.  There  is  a  very  prevalent  opinion  that 
the  virus  gains  entrance  through  some  solution  of  continuity  in  the  skin  in  a  large 
number  of  cases,  and  that  this  is  the  common  mode  of  infection  in  bubonic  cases. 
That  the  infection  can  be  acquired  in  this  way  there  is  no  reason  to  doubt,  as 
many  painful  instances  of  accidental  inoculation  amply  testify,  but  that  it  is  the 
common  mode  of  infection  is  far  from  being  conclusively  proved.  In  the  cases  just 
described,  which  were  all  bubonic,  no  skin  lesion  was  found  at  the  time  of  the 
post-mortem  examination  which  might  have  served  as  the  point  of  entrance, 
although  it  is  possible  that  a  trivial  woimd,  quite  sufficient  for  this  purpose,  might 
have  entirely  disappeared  by  the  time  of  the  patient's  death. 

The  preponderance  of  inguinal  buboes  is  quite  in  harmony  with  what  has  been 
found  in  other  epidemics,  and  this  lesion  would  appear  to  be  altogether  too 
regularly  fi:equent  in  its  incidence  to  admit  of  explanation  on  the  ground  of 
accidental  inoculation  through  the  skin  of  the  lower  extremity.  One  would  expect 
the  primary  bubo  to  be  as  common,  if  not  commoner,  in  the  axilla  did  the  bacillus 
usually  gain  entrance  through  the  skin.  A  peculiarity  of  the  bacillus  exhibited  in 
3.  number  of  specimens  is  of  special  interest  in  this  connection,  namely,  its  tendency 


84 


to  pass  out  of  the  blood  stream.  In  the  capillary  vessels  the  bacillus  is  distributed 
along  the  internal  surface  of  the  vessels,  and  is  frequently  seen  to  have  passed 
through  their  walls  into  the  perivascular  spaces.  In  this  fact  most  probably  lies 
the  explanation  of  the  relative  frequency  of  the  lesion  in  the  lymphatic  glands. 
There  is  reason  to  believe  that  in  plague,  as  in  some  other  infective  diseases, 
infection  of  the  blood  takes  place  during  the  period  of  incubation,  but  that  the 
bacillus  pestis  during  this  period  tends  to  pass  out  of  the  blood  vessels  into 
lymph  channels  in  the  majority  of  cases,  to  be  ultimately  arrested  in  a  particular 
chain  of  glands,  most  commonly  the  inguinal,  and  give  rise  to  the  characteristic 
bubo. 

In  one  of  the  cases  (Baby  M.),  the  evidence  points  to  infection  by  the  nostrils 
and  mouth  at  the  time  of  birth.  Here,  however,  it  will  be  apparent  that  the 
process  of  infection  was  more  like  that  of  an  experimental  inoculation  than  infection 
under  ordinary  circumstances. 

In  a  few  of  the  cases,  at  the  beginning  of  the  epidemic,  the  symptoms  were 
chiefly  gastro-intestinal,  and  pointed  to  infection  by  ingesta.  but  no  corroborative 
evidence  of  this  was  elicited. 


BACTERIOLOGICAL  DIAGNOSIS. 

The  diagnosis  of  plague,  in  its  earlier  stages  at  least,  can  readily  be  placed 
beyond  doubt  by  bacteriological  methods.  The  application  of  these  methods  was 
therefore  of  the  utmost  importance  at  the  commencement  of  the  epidemic,  and  in 
connection  with  doubtful  cases  of  glandular  enlargement  and  pneumonia.  The 
procedure  was  determined  by  the  nature  of  the  lesion,  the  material  for  examination 
having  to  be  obtained  from  the  bubo,  the  blood,  or  the  sputum,  as  the  case 
might  be. 

The  successful  puncture  by  means  of  a  hypodermic  needle  of  small  painful 
glandular  swellings  (for  it  was  chiefly  in  connection  with  these  that  any  doubt 
existed)  and  the  withdrawal  of  some  fluid  for  examination  was  a  matter  of  con- 
siderable difficulty,  especially  in  children,  and  more  especially  amidst  the  squalor 
of  the  patient's  surroundings.  Further,  the  time  required  for  bacteriological  proof 
was  apt  to  run  into  several  days,  if  animal  experiments  were  required.  The 
application  of  the  bacteriological  test  to  doubtful  cases  in  their  own  homes  was 
therefore  not  found  to  be  of  much  practical  value  from  an  administrative  point  of 
view,  and  these  cases  were  accordingly  removed  to  hospital  at  once  for  observation. 

The  supposititious  danger  of  infecting  surrounding  tissues,  or  even  of  causing 
a  general  blood  infection,  and  so  changing  a  simple  bubonic  case  into  one  of 
septicaemia,  by  puncture  of  the  bubo,  was  always  kept  in  view,  but  in  no  case  did 
any  local  or  general  disturbance  follow  to  give  it  any  credence.  The  operation  was 
accomplished  in  every  instance  without  any  apparent  harmful  effect. 

A  number  of  patients  with  ordinary  inflammatory  swellings  were  brought 
under  observation  by  virtue  of  the  general  suspicion  extant  regarding  all  glandular 
lesions.  Clinically  but  little  doubt  remained  as  to  the  true  nature  of  these  cases, 
and  bacteriological  examination  served  at  once  to  remove  any  uncertainty  as  to  the 
diagnosis.  In  this  connection  also  the  following  case  has  a  special  interest  of  its 
own : — A  boy,  about  ten  years  of  age,  died  somewhat  suddenly  at  home,  under 
circumstances  of  a  suspicious  nature,  in  view  of  the  presence  of  plague  in  the  city. 
The  probability  of  plague  was  further  increased  by  the  history  of  the  illness  and 
the  presence  of  enlarged  lymphatic  glands.  The  body  was  removed  to  Belvidere 
Hospital  for  post-mortem  examination,  with  the  result  that  an  acute  suppurative 
tonsillitis  was  found  associated  with  considerable  enlargement  of  the  deep  cervical 
glands  and  tumefaction  of  the  lymphatic  glands  generally.  The  lymphoid  tissues 
generally  were  in  a  state  of  extreme  hyperplasia.   No  plague  bacilli  were  discovered 


85 


in  the  blood  or  organs.  A  general  tumefaction  of  the  lymphatic  glands  was  also 
observed  in  two  fatal  cases  of  broncho-pneumonia,  which  came  under  suspicion  by 
reason  of  their  occurrence  in  a  tenement  from  which  a  case  of  plague  had  been 
removed. 

A  case  of  pneumonia  which  was  removed  from  the  plague-infected  area  to 
one  of  the  general  hospitals  gave  rise  to  the  suspicion  of  plague.  Bacterioscopic 
examination  showed  pneumococcal  infection  only.  This  was  one  of  a  number 
of  pneumonic  cases  that  came  under  observation,  and  required  verification  by 
bacteriological  methods. 

An  equipment  was  provided  for  the  use  of  medical  members  of  the  staff.  It 
consisted  of  a  sterilised  hypodermic  syringe  and  needle  placed  in  a  sterilised  glass 
tube,  which  in  turn  was  placed  within  a  box  of  convenient  size.  The  syringe  and 
needle,  after  being  charged  with  fluid  from  the  suspected  swelling,  were  replaced 
in  the  glass  tube,  and  conveyed  at  once  to  the  laboratory.  By  these  means 
personal  risk  to  the  physician  and  others  was  reduced  to  a  minimum,  and  the 
morbid  material  was  received  in  a  condition  to  be  at  once  subjected  to  examination 
by  the  microscope,  by  cultures,  and  by  inoculation  experiments. 


PKECAUTIONS  OBSERVED  IN  CONNECTION  WITH  POST-MORTEM 
EXAMINATIONS  AND  INOCULATION  EXPERIMENTS. 

At  post-mortem  examinations  the  utmost  precautions  were  observed  to  prevent 
any  spread  of  infection.  The  sheet  which  had  enveloped  the  body  was  at  once 
burned.  Fluids  from  the  body  were  received  in  vessels  containing  perchloride  of 
mercury  solution  (1  :  500)  before  being  run  into  the  drain.  All  sponges  were  burned 
immediately  after  use.  The  body  was  thoroughly  washed  with  perchloride  solution, 
and  after  its  removal  in  fresh  dressing,  the  instruments,  the  table,  and  the  floor 
were  thoroughly  disinfected.  The  Pathologists'  hands  were  protected  by  carbolised 
vaseline  and  thin  indiarubber  gloves. 

Film  preparations  on  slides  from  the  fresh  tissues,  for  microscopic  examination, 
were  fixed  by  completely  immersing  the  glass  for  three  minutes  in  absolute  alcohol. 
This  had  the  advantage  over  the  heat  of  the  flame  as  a  fixing  agent,  that  it  secured 
at  the  same  time  complete  sterilization  of  the  whole  film.  Specimens  were  washed 
in  a  fine  stream  of  water  over  a  basin  containing  perchloride  of  mercury  solution 
(1 : 1000)  and  dried  with  small  squares  of  cloth,  which  were  afterwards  destroyed  by 
burning. 

The  animals  experimentally  inoculated  with  plague  material  or  cultures  for  the 
purpose  of  diagnosis  were  kept  under  conditions  which  aimed  at  preventing  access 
of  rats,  mice,  or  flies.  Mice  were  used  in  preference  to  guinea-pigs  as  giving  residts 
more  rapidly,  and  as  being  more  easily  and  safely  accommodated. 

The  mice  were  kept  in  ordinary  museum  jars  provided  with  a  tight-fitting  lid 
of  finely  perforated  zinc.  Accommodation  for  guinea-pigs  on  similar  lines  in  large 
jars  was  found  to  be  quite  unsuitable,  and  was  at  once  abandoned  for  a  large  glass 
cylinder,  open  at  both  ends.  This  was  supported  over  a  disinfectant  in  a  deep 
tray,  while  in  the  bottom  was  placed  a  raised  perforated  zinc  platform,  and  on  the 
top  a  tight-fitting  perforated  zinc  lid.  Such  a  cylinder  had  the  double  advantage 
of  permitting  a  constant  circulation  of  air  and  immediate  disinfection  ,of  the 
excreta.  At  first  the  jars  containing  the  animals  were  placed  in  a  large  tin  case, 
24  inches  by  24  inches  by  30  inches,  provided  with  a  finely  perforated  zinc  lid, 
with  the  object  of  still  further  guarding  against  the  access  of  other  animals,  but 
with  the  completion  of  a  special  room  (which  was  actually  in  process  of  construction 
when  the  outbreak  took  place)  the  use  of  the  metal  case  was  no  longer  found  to  be 
necessary, 


86 


The  room  which  has  been  set  apart  for  the  reception  of  plague-infected 
animals  is  13  feet  by  9  feet  by  8|-  feet,  with  concrete  floor.  It  is  heated  by  a  gas 
stove,  is  well  lighted,  and  has  cross  ventilation  by  the  windows. 

The  dissection  of  the  animals  which  succumbed  to  the  disease  was  carried  out 
so  that  no  infective  material  should  escape  destruction  or  sterilisation.  The  skin 
of  the  animals  was  thoroughly  soaked  with  lysol.  Mice  were  fixed  on  cardboard, 
and  on  completion  of  the  examination  the  carcase  and  cardboard  were  cremated 
together.  Guinea-pigs  were  likewise  cremated  after  examination.  The  board  on 
which  they  were  placed  for  examination  rested  on  the  bottom  of  a  deep  enamelled 
tray,  and  was  steeped  over  night  in  5  per  cent,  carbolic  solution. 


EXAMINATION  OF  RATS  IN  RELATION  TO  THE  OUTBREAK  OF 

PLAGUE  IN  GLASGOW. 

The  part  played  by  rats  in  disseminating  the  infection  of  plague  is  still  involved 
in  much  uncertainty.  The  literature  of  the  subject  clearly  testifies  that  a  number 
of  plague  epidemics  have  been  immediately  preceded  by  or  intimately  associated  with 
the  disease  in  rats.  In  some  of  these  epidemics  there  seems  to  be  no  doubt  that 
the  rodents  were  the  means  of  diffusing  the  infection  and  transmitting  it  to  man. 
On  the  other  hand,  there  have  been  epidemics  in  which  the  rat  has  not  appeared 
to  play  any  part,  and  some  also  in  which  a  great  mortality  amongst  the  rats,  even 
in  the  dwellings  of  the  people,  was  not  accompanied  by  a  correspondingly  serious 
■outbreak  of  human  plague.  It  would  appear,  therefore,  that  as  a  carrier  of  infection 
from  port  to  port,  and  as  a  distributor  of  infection  on  land,  the  rat  is  presumably  an 
important  factor;  but  the  assumption  that  it  necessarily  plays  a  part  in  dis- 
seminating infection  during  an  epidemic  of  human  plague  is  not  warranted  by  facts. 

In  Glasgow,  whatever  the  original  source  of  the  infection  may  have  been,  there 
was  no  evidence  that  rats  played  any  part  in  carrying  it  amongst  those  who  were 
attacked  by  the  disease.  From  the  end  of  August  till  the  middle  of  November, 
236  rats  were  caught  within  the  plague  area — mostly  in  the  neighbourhood  of 
infected  houses — and  no  trace  of  the  disease  was  discovered  in  any  of  them. 
Further,  no  exceptional  mortality  or  migration  was  noticed  amongst  the  rats  in 
this  or  any  other  part  of  the  city,  either  before,  during,  or  after  the  epidemic.  A 
continual  vigilance  has  been  exercised  by  the  sanitary  and  cleansing  staff's  for 
evidence  of  any  unusual  disease  or  mortality  among  the  rats,  and  the  additional 
number  of  124  was  submitted  for  examination  from  all  parts  of  the  town  during 
the  winter.  In  the  great  majority  it  was  found  that  death  had  taken  place  as 
the  result  of  violence,  while  in  no  instance  was  there  any  sign  of  plague. 


PLATE  I. 


PLAGUE— ILLUSTRATIONS  OF  MORBID  ANATOMY. 


DESCRIPTION   OF   PLATE  I. 


Fig.  1. — Inguinal  bubo  in  longitudinal  section,  composed  of  one  large  and  several  smaller  glands. 

Large  gland  haemorrhagic  and  necrotic.  Surrounding  tissues  infiltrated  with  blood. 
Formalin.    Natural  size.    (Case — G.  H.    No,  18.) 

Fig  2. — Cervical  buboes  of  infant  in  longitudinal  and  transverse  section,  the  darker  rounded  areas  in 
figures  being  congested,  hBemorrliagic,  and  partly  necrosed  glands.  Formalin.  Natural 
size.    (Case— Baby  M.    No.  28. ) 

Fig  3. — Kidneys  of  infant,  showing  hsgmorrhage  foci  in  the  pyramids  and  hyperaemia.  One  Suprarenal 
Capsule  shown,  altered  by  coagulation  necrosis  and  haemorrhage.  Formalin.  Natuiul 
size.    (Case— Baby  M.    No.  28.) 

Fig.  4. — Liver  of  infant.  Transverse  section,  presenting  a  number  of  small  plague  tubercles  (the 
white  circular  points  from  0'5  to  3  mm.  in  diameter),  and  very  marked  cloudy  swelling 
(the  greyish  hazy  areas)..    Formalin.    Natural  size.    (Case — Baby  M.    No.  28.) 

Fig.  5.' — Right  lung,  posterior  half,  showing  large  areas  of  necrosis  (white)  in  midst  of  pneumonic 
tissue.  To  the  right  is  shown  a  mass  of  enlarged  glands  which  lay  in  fi'ont  of  the  trachea 
and  impinged  on  the  pericardium^   Formalin,   -fths  natural  size.  (Case — R.  M.  No.  25.) 

Fig.  6. — Left  lung,  posterior  portion,  showing  pneumonic  consolidation  of  the  lower  lobe,  with 
extensive  necrosis  (the  whiter  areas).  Lobular  consolidation,  with  some  necrosis  in 
upper  lobe.    Alcohol,    -fths  natural  size.    (Case — R.  M.    No.  25. ) 

Fig.  7. — Right  inguinal  bubo.  Specimen  represents  mass  of  tissue  from  Scarpa's  triangle  to  internal 
iliac  artery.  Under  the  skin  (on  left  of  figure)  is  shown  a  great  mass  of  necrotic  gland 
tissue.  Towards  the  artery  (on  the  right)  is  the  i-ounded  contour  of  a  large  abscess, 
impinging  on  the  bladder  wall — a  part  of  which  is  shown  below.  Alcohol,  -l-rd  natural 
size.    (Case — J.  B.    No.  1,) 


Plate  I. 


7. 


PLATE  II. 


PLAGUE— FILM  PREPARATIONS  FROM  FRESH  TISSUES. 


DESCRIPTION   OF   PLATE  II. 


Fig.  8. — Bacillus  pestis  from  inguinal  bubo.  vShows  the  bacillus  in  process  of  degeneration  and 
extinction.  (Great  numbers  of  degenerated,  unstained,  bacilli  occupied  the  field,  but 
their  forms  are  scarcely  visible  in  the  picture.)  Gentian- violet.  x  1000.  (Case — 
G.  H.    No.  18.) 

Fig.  9. — Bacillus  pestis,  pneumococcus  and  streptococcus  from  lung.  A  distinct  halo  or  capsule  is 
shown  by  some  of  the  plague  bacilli  in  lower  part  of  figure.  Blood  corpuscles  appear 
vacuolated  owing  to  imperfect  fixation,  Carbol-fuchsin.  x  1000.  (Case — Mrs.  M. 
No.  22.) 

Fig.  10. — Bacillus  pestis  and  pneumococcus  from  retro-peritoueal  bubo,  to  show  mixed  infection. 
Carbol-fuchsin.     x  1000.    (Case— Mrs.  M.    No.  22.) 

Fig.  11. — Bacillus  pestis  from  spleen.    Gentian-violet.     x  1000.    (Case — Mrs.  M.    No.  22.) 

Fig.  12. — Bacillus  pestis  from  cervical  bubo  of  infant.  A  pure  infection  ;  bacilli  in  great  number. 
Carbol-thionin-blue.     x  1000.    (Case— Baby  M.    No.  28.) 

Fig.  13. — Bacillus  pestis  from  pneumonic  lung.    Carbol-fuchsin.     x  1000.    (Case — R.  M.    No,  25.) 

Fig.  14.  —Bacillus  pestis  from  spleen  of  infected  mouse,  showing  the  bacillus  in  very  typical  form  and 
in  active  proliferation.    Carbol-fuchsin.     x  1000. 

Fig.  15. — Bacillus  pestis  in  blood  of  infected  mouse.    Carbol-fuchsin.     x  1000. 


Plate  II. 


PLATE  III. 


PLAGUE— MICROSCOPICAL   ILLUSTRATIONS   OF   MORBID  ANATOMY, 


DESCRIPTION    OF    PLATE  III. 


Fig.  16. — Cervical  bubo,  showing  several  lymphatic  glands  with  plague  bacilli  massed  in  the  periphery 
of  each  gland  in  enormous  numbers.  Carbol-thionin-blue  and  Eosin.  x  60.  (Case — 
BabyM.    No.  28.) 

Fig.  17. — Lung,  showing  an  area  of  alveoli  (in  the  distribution  of  a  bronchiole)  occupied  by  dense 
masses  of  B.  pestis  (black  in  figure).  The  central  portion  has  undergone  necrosis. 
Carbol-thionin-blue.     x  60.    (Case— Baby  M.    No.  28.) 

Fig.  18. — Lung,  showing  a  large  vessel  with  its  perivascular  spaces  occupied  by  B.  pestis.  Carbol- 
thionin-blue  and  Eosin.     x  60.    (Case— Baby  M.    No.  28. ) 

Fig.  19. — Kidney,  showing  a  portion  of  the  cortex  in  which  B.  pestis  has  developed  between  the 
tubules  in  great  masses,  and  leucocyte  infiltration  in  an  early  stage.  Carbol-thionin- 
blue  and  Eosin.     X  100.    (Case— Baby  M.    No.  28.) 

Fig.  20.  —Suprarenal  gland,  showing  part  of  fibrous  capsule  (at  top  of  figure),  masses  of  B.  pestis  in 
the  cortex,  and  coagulation  necrosis  of  the  deeper  tissue  as  evidenced  by  disappearance 
of  neuclei.    Carbol  thionin-blue.     x  60.    (Case — BabyM.    No.  28.) 


Fig.  21. — Liver,  showing  the  distribution  in  the  organ  of  small  isolated  groups  of  B.  pestis  (the  black 
patches  in  right  half  of  figure)  Great  distension  of  vascular  system.  Carbol-thionin- 
blue  and  Eosin.     X  60.    (Case— Baby  M.    No.  28.) 


Plate  III. 


PLATE  IV. 


PLAGUE— MICROSCOPICAL  ILLUSTRATIONS   OF  MORBID  ANATOMY. 


DESCRIPTION    OF   PLATE  IV. 


Fig.  22. — Liver.  Same  section  as  in  Fig  22,  showing,  under  a  higher  power,  one  of  the  bacillary  foci 
with  commencing  aggregation  of  leucocytes.  Carbol-thionin-blue  and  Eosin.  x  250. 
(Case— Baby  M.    No.  28.) 

Fig.  23. — Liver  of  plague-infected  mouse  (which  died  on  sixth  day),  for  comparison  with  Fig.  23. 

The  metastatic  process  is  more  advanced,  showing  abscess  formation  and  partial  necrosis, 
and  the  disappearance  of  the  bacilli.  The  abscess  has  extended  through  the  wall  of  an 
intralobular  vein.    Carbol-thionin-blue  and  Eosin.     x  250. 

Fig.  24. — Margin  of  bronchial  gland,  showing  the  fibrous  capsule,  with  three  greatly  distended  blood- 
vessels, and  a  small  portion  of  the  periphery  of  the  gland  occupied  by  bacilli  in  almost 
homogeneous  mass  (black  in  figure).  The  darker  parts  in  the  capsule  are  also  due  to 
bacillary  invasion.    Carbol-thionin-blue  and  Eosin.     x  60.    (Case — G.  H.    No.  18.) 

Fig.  25, — Right  inguinal  gland  (which  was  only  slightly  enlarged).  Right  half  of  field  shovi  s  a  tract  of 
necrosis,  associated  with  invasion  of  B.  pestis.  Left  half  represents  normal  tissue  free 
from  bacilli.    Carbol-thionin-blue  and  Eosin.     x  1000.    (Case — G.  H.    No.  18.) 

Fig.  26. — Spleen,  showing  the  distribution  of  B.  pestis  throughout  the  tissue.  Only  a  comparative!}' 
small  number  of  the  bacilli  in  focus.  Carbol-thionin-blue  and  Eosin.  x  450.  (Case — 
G.  H.    No.  18.) 

Fig.  27. — Retroperitoneal  bubo,  showing  almost  complete  necrosis  of  the  tissues.  A  large  vessel  in 
the  middle  of  the  field  is  filled  with  leucocytes,  and  a  few  leucocytes  are  scattered 
throughout  the  field.  The  darker  shading  in  the  figure  indicates  the  presence  of  enormous 
numbers  of  plague  bacilli,     x  60.    (Case— Mrs.  M.    No.  22.) 


Plate  IV. 


PLATE  V. 


PLAGUE— BACILLUS  PESTIS  IN  CULTURE. 


DESCRIPTION   OF   PLATE  V. 


Fig.  28. — Culture  of  B.  pestis  on  agar.    Colonies  very  numerous  and  small.    (Case — R.  M.    No.  25.) 

Fig.  29. — Mixed  growth  of  B,  pestis  and  pneumococcus  on  agar.  The  plague  colonies,  being  few  in 
number,  have  attained  a  large  size.  The  pneumococcus  colonies  are  small,  and  only  just 
visible.    (Case— G.  H.    No.  18.) 

Fig.  30. — Bacillus  pestis.  Culture  on  agar  after  twenty -four  hours.  Carbol - fuschin.  x  1000. 
(Case— G.  H.    No.  18.) 

Fig.  31. — Bacillus  pestis  in  chains.  Culture  in  bouillon  after  forty-eight  hours.  Carbol-fuschin. 
X  1000.    (Case  =  R.  M.    No.  25.) 

Fig.  32. — Bacillus  pestis  in  chains.  Culture  in  bouillon  after  four  days.  Bacilli  swollen,  and  many 
of  them  degenerated,  so  that  they  do  not  take  the  stain  well.  Carbol-fuschin.  x  1000. 
(Case— R.  M.    No.  25.) 

Fig.  33. — Bacillus  pestis.  Involution  forms  from  a  six  weeks  old  culture  on  ordinary  agar.  A  faint 
groundwork  is  formed  of  degenerate  unstained  bacilli.  Carbol  -  fuschin.  x  1000. 
(Case— R.  M.    No.  25.) 


Fig.  34. — Bacillus  pestis  from  old  agar  culture,  to  show  the  common  appearance  presented  by  old 
cultures,     x  1000.    (Case— R.  M,    No.  25.) 


Plate  V. 


33. 


34. 


1*^ 


CORPORATION    OF  GLASGOW. 


CENSUS,  1901. 


REPORT 


ON 


fiLASGOW;  ITS  SANITARY  DISTRICTS  AND  MUNICIPAL  WARDS. 


BY 


A.  K.  CHALMERS,  M.D., 

Medical  Officer  of  Health. 


GLASGOW: 

PRINTED  BY  ROBERT  ANDERSON,   142  WEST  NILE  STREET. 


CONTENTS.  " 


PAGE 

Prefatory  Note,  5 

Population,  7 

Rate  of  Increase  in  Several  Periods,          _           .           .           _           _  7 

Institutional  Population,    ------          -  8 

Shipping  Population,          -           -           -           -           -           -           -  10 

Age  and  Sex  Distribution,             -           -           -           -           -           -  11 

Comparison  of  Natural  Increase  in  each  Sex  with  Census  Increase,           -  12 

Proportion  of  each  Sex  Living  at  Several  Age  Periods,      -          -          -  13 

Proportion  of  Population  Born  in  Ireland,             -           -           -           -  14 

Housing,  14 

Number  and  Rate  of  Increase,       -           -           -           -           -           -  14 

The  Size  of  the  Average  House  and  the  Average  Number  of  its  Occupants,  15 

The  Average  House  of  Glasgow  and  other  Towns  in  Scotland  compared,    -  16 

Grouping  of  Population  in  Houses  of  various  sizes,            -           -           -  17 

One- Apartment  Houses,  Old  Glasgow,  1891  and  1901,      -          -          -  18 

Definition  of  a  House  for  Sanitary  and  Census  purposes,  contrasted,         -  19 

"  Farmed-out "  Houses,      -           -           -           -           -           -           -  20 

Question  of  Overcrow'ding,    '        -                      -           -"         -           -  21 

How  far  can  the  condition  in  Scotland  and  England  be  compared,  -  21 
Average  Cubic  Space  per  House  in  Glasgow  in  old  and  recently  erected 

Houses,           -          -          -          -          -          -          -          -  22 

Sanitary  Divisions  of  the  City,  24 

Intercensal  Changes  of  Population  and  in  House  Accommodation,  -  25 
Question  of    Pressure    in  One  and  Two  Apartment  Houses  in  some 

Districts,  and  the  Cause  thereof,         -           -           -           -           -  26 

Empty  Houses,       --------  29 

Formula  for  Calculating  the  Annual  Increase,  19011911,        -          -  30 

Average  P^entals,    --------  30 

Glasgow's  Outer  Ring,        -----                      -  31 

Question  of  Sub-Dividing  the  Municipal  W^vkds  as  a  Substitute  for 

the  Present  Sanitary  Districts,        -          -          -          -          -  31 


Index  to  Tables  in  Appendix  — 

SANITARY  DISTRICTS. 

Table  I. — Comparative  Statement  of  Population,  Houses  (Inhabited  and 
Empty),  windowed  rooms,  persons  per  aci'e,  per  house,  and  per  room, 
and  percentage  of  Irish-born,  at  the  Census  periods  1891  and  1901  in 
the  City  and  Sanitary  Districts  thereof,         -  -  -  -  38 


4 


Table  II. — Age  and  Sex  of  the  Population,  distinguishing  Institutions  and  page 
Shipping,  also  number  of    Irish-born,  in    the  City  and  Sanitai-y 
Districts,         ........  40 

Table  III. — Age  and  Sex  of  the  Inmates  of  each  Institution  within  the 
Sanitary  Districts  of  the  City,  also  number  of  windowed  rooms,  and 
number  of  Irish-born  therein,  -  -  ...  44 

Table  IV. — Proportion  per  cent,  of  each  Sex  living  at  various  periods  of 
life  of  the  Total  Population  (exclusive  of  the  inmates  of  Institutions 
and  Shipping)  in  each  Sanitary  District  and  in  the  City,  and  of  the' 
total  inmates  of  Institutions  and  Shipping,     -  -  -  .  48 

Table  V. — Inhabitants  grouped  according  to  the  size  of  their  houses,  and 
also  the  number  of  windowed  rooms,  in  the  City  and  Sanitary 
Districts,         -  ...  .  .  .  .  50 

Table  VI. — Proportion  per  cent,  of  Houses  of  various  sizes  and  of  the 

Total  Population  dwelling  in  them  in  the  City  and  Sanitary  Districts,  5 1 

Table  VII. — Average  number  of  Inmates  per  House  of  each  size  and  of 
all  sizes,  also  percentage  of  Empty  Houses,  in  the  City  and  Sanitary 
Districts,         -  -  -  -  -  -  -  -  52 

MUNICIPAL  WARDS. 

Table  VIII. — Statement  of  Acreage,  Population,  Hoiises  (Inhabited  and 
Empty),  windowed  rooms,  persons  per  acre,  per  house,  and  per  room, 
percentage  of  Irish-born,  in  the  City  and  Municipal  Wards  thereof,   -  53 

Table  IX. — Age  and  Sex  of  the  Population,  distinguishing  Institutions 
and  Shipping,  also  number  of  Irish-born,  in  the  City  and  Municipal 
Wards,  54 

Table  X. — Proportion  per  cent,  of  each  Sex  living  at  various  periods  of 
life  of  the  Total  Population  (exclusive  of  the  inmates  of  Institutions 
and  Shipping)  in  each  Municipal  Ward  and  in  the  City,  and  of  the 
Total  Inmates  of  Institutions  and  Shipping,    -  -  -  -  58 

Table  XI. — Inmates  of  each  Institution  within  the  Municipal  Wards  of 
the  City,  also  number  of  windowed  rooms  and  number  of  Irish-born 
therein,  go 

Table  XII. — Inhabitants  grouped  according  to  the  size  of  their  houses, 
and  also  the  number  of  windowed  rooms,  in  the  City  and  Mxmicipal 
Wards,  -  -  -  -  -  -  -  -  61 

Table  XIII. — Proportion  per  cent,  of  Houses  of  various  sizes  and  of  the 

Total  Population  dwelling  in  them  in  the  City  and  Municipal  Wards,  62 

Table  XIV. — Average  number  of  Inmates  per  House  of  each  size  and  of 
all  sizes,  also  percentage  of  Empty  Houses,  in  the  City  and  Municipal  „ 
Wards,  -  -  -  -  -  -  -  -  63- 

Table  XV. — Relation  of  present  Sanitary  Districts  to  the  Municipal 

Wards  of  the  City,      -  -  -  -  -  -  -  64 

Table  XVI. — Number  of  Houses  for  the  erection  of  which  authority  has 
been  granted  by  the  Dean  of  Guild  Court  during  each  year  from  1st 
September,  1891,  to  31st  August,  1901,         -  ...  65 


PEEFATORY  NOTE. 


Througli  the  courtesy  of  the  Registrar  General,  and  with  the  approval 
of  the  Secretary  for  Scotland,  the  facilities  which  had  been  granted  to  the 
Medical  Officer  of  Health  for  the  City  in  1871,  1881,  and  1891,  were  renewed 
on  the  occasion  of  the  recent  Census ;  but  the  altered  requirements  of  the 
Census  (Great  Britain)  Act  of  1900,  and,  more  especially,  the  provision  contained 
in  Section  9  thereof,  led  to  an  alteration  in  the  method  by  which  the  extraction 
of  the  details  which  are  dealt  with  in  the  following  pages  was  accomplished- 
This  occasioned  only  an  unimportant  delay  in  obtaining  the  information,  but 
it  implied  the  prosecution  of  the  work  of  extracting  in  Edinburgh,  when  the 
books  were  in  the  possession  of  the  Registrar-General,  instead  of  as  formerly  while 
they  were  still  here  in  the  custody  of  the  Town-Clerk.  It  was  thus  necessary 
to  obtain  the  use  of  suitable  premises  in  Edinburgh  in  which  the  work  could 
be  done,  and  Sir  James  D.  Marwick,  Town-Clerk,  whose  courteous  and  continued 
effort  to  obtain  the  requisite  facilities  and  to  further  the  progress  of  the 
work  I  desire  most  heartily  and  thankfully  to  acknowledge,  brought  our  needs 
before  Mr.  Hunter,  Town-Clerk,  Edinburgh,  through  whose  kindly  interest  a  large 
hall,  attached  to  the  Collector's  Office  there,  was  placed  at  our  disposal. 

I  also  desire  to  acknowledge  the  cordial  assistance  rendered  by  Mr.  Gunn, 
Collector,  and  his  fellow  officials,  in  connection  with  the  preliminary  arrange- 
ments and  during  the  progress  of  the  work. 

A  staff  of  37  clerks  was  thereafter  employed ;  the  work  of  extracting  was 
begun  on  18th  July  and  finished  on  27th  July. 

As  on  the  occasion  of  the  former  Census,  this  was  carried  on  under  the 
■direct  personal  superintendence  of  Mr.  Elborn,  Statistical  Clerk  to  the 
Department  here. 

In  connection  with  a  suggestion  to  reconstitute  the  Sanitary  Districts 
within  the  Municipal  Wards,  Tables  have  been  prepared  which  for  the  first 
time  contain  details  of  the  Housing  and  Age  Distribution  of  the  population 
in  these  latter. 

A.  K.  CHALMERS, 

Medical  Officer  of  Health. 

Sanitary  Chambers, 

Glasuow,  January,  1902. 


CENSUS  1901— GLASGOW. 


POPULATION. 

At  the  Census  on  the  night  of  Sunday,  31st  March,  1901,  the 
population  of  the  City  of  Glasgow  numbered  761,712.*  The  area  of  the  City- 
extends  to  12,681  acres;  the  number  of  persons  per  acre  is  60.f  At  the  Census 
on  5th  April,  1891,  the  population  numbered  658,073,  of  which  565,710  were 
resident  in  Old  Glasgow  and  92,363  in  the  districts  added  to  the  City  in  the 
following  November. 

The  increase  during  the  present  decade  amounts,  therefore,  to  103,639  persons, 
and  represents  a  rate  equal  to  15*75  per  cent.  The  extent  and  source  of  this  are 
alike  interesting.  Numerically  it  is  almost  twice  that  of  1881-91,  and  four  times 
that  of  1871-81.  During  the  decade  1861-71  the  increase  was  at  the  rate  of  21-64 
per  cent.,  in  1871-81  it  fell  to  4  per  cent.,  while  during  1881-91  it  was  10  62  per 
cent.  But  the  natural  increment  alone,  i.e.,  the  excess  of  births  over  deaths  during 
1861-71  was  equal  to  an  increase  of  11-5  per  cent,  on  the  1861  population,  and 
although  this  was  maintained  at  a  fractionally  higher  rate,  viz.,  11-7  per  cent., 
during  1871-81,  the  actual  increase  at  the  Census  of  1881  amounted  only  to  4  per 
cent,  on  the  1871  population,  while  during  1881-91  the  actual  increase  fell  short 
by  2"1  of  the  rate  per  cent,  which  the  excess  of  births  over  deaths  represented. 
The  actual  increase  represents  the  balance  between  births  plus  immigrants  on  the 
one  hand  and  deaths  plus  emigrants  on  the  other,  so  that  in  the  period  1871  to 
1891  the  City  was  losing  a  considerable  portion  of  its  natural  growth  through 
emigration,  or  (what  more  correctly  describes  the  actual  movement)  through  the 
overflow  of  its  excess  population  into  the  surrounding  districts — an  artificial 
restriction  on  the  growth  of  its  population  which  the  extension  of  the  boundaries 
in  1891  has  removed. 

The  following  Table  has  been  compiled  to  show  this : — 


Census  Period. 

Births. 

Deaths. 

Difference 
representing 
Natural  Increase. 

Census 
Increase. 

1861-71,   

178,582 

132,260 

46,522 

87,532 

1871-81,   

200,766 

143,116 

57,650 

19,674 

1881-91  (Old  Glasgow), 

196,767 

131,446 

65,321 

54,295 

1892-1901$  (Greater  Glasgow), 

218,269 

142,974 

75,295 

103,639 

*  The  Registrar-G-eneral  gives  761,665  in  his  preliminary  Census  Tables,  but  until  every  entry 
has  beeo  scrutinised  and  verified,  discrepancies  will  exist  between  summaries  from  different  sources,  and 
the  difference  of  47  here  shown  will  introduce  no  error  of  material  value. 

+  At  the  Census  of  1891  Glasgow  contained  6,111  acres,  and  its  density  was  93  persons  per  acre  ; 
the  extension  in  the  following  November  added  5.750  acres  and  92,363  persons,  reducing  the  density  to 
56.  In  1896  Bellahouston  Park  and  district,  containing  450  acres,  with  a  population  in  1891  of 
510,  was  annexed  ;  and  in  1899  Richmond  Park  and  district,  on  the  south  side  of  the  Clyde,  and  the 
districts  of  Provanmill  and  Blackhill,  on  the  north,  with  an  acreage  of  370  and  a  population  in  1891  of 
385,  were  annexed. 

X  The  details  for  April-December,  1891,  are  not  available.    (See  text.) 


8 


The  figures  for  the  decade  just  closed  cannot  be  stated  with  precision 
because  the  births  and  deaths  in  the  added  districts  during  the  last  nine  months 
of  1891  are  not  readily  available.  In  the  Table  these  are  given  from  1st 
January,  1892,  to  31st  March,  1901,  and  show  an  excess  of  births  over  deaths 
of  75,295.  Assuming  a  rate  for  both  births  and  deaths  to  have  obtained  during 
the  nine  months  of  1891  for  which  the  records  are  not  available  similar  to  that 
which  obtained  throughout  the  remainder  of  the  decade,  we  shall  only  slightly 
overstate  the  actual  excess  of  births  at  81,405,  which  leaves  22,234  of  the  Census 
increase  to  be  accounted  for  by  excess  of  immigration  over  emigration  during  the 
whole  period.  We  shall  see  later  in  what  proportion  males  and  females  respectively 
contribute  to  this,  but  for  the  present  it  may  be  observed  that  the  proportion 
which  the  natural  increment  bears  to  the  total  increase  in  the  past  decade  is  78 
per  cent,  as  compared  with  53  per  cent,  during  1861-71. 

Rate  of  Increase  in  Several  Towns  Compared.* 
The  following  Table  is  interesting  for  the  reason  that  although  in  several 
towns,  both  in  England  and  Scotland,  the  rate  of  increase  in  Grlasgow  has  been 

exceeded,  no  population  approaching  it  in  size  has  approached  it  in  the  rate  of 
increase  : — 


Towns. 

Enumerated  Population. 

Increase 
per  cent. 

1891. 

1901. 

1891-1901 

London, 

4,228,317 

4,536,063 

7-28 

Liverpool, 

629,548 

684,947 

8-80 

Manchester,  ... 

505,368 

543,969 

7-64 

Birmingham, 

478,113 

522,182 

9-22 

Leeds,  ..." 

367,505 

428,953 

16-72 

Sheffield,   

324,243 

380,717 

17-42 

Edinburgh,  ... 

276,066 

316,793 

14-75 

Dundee, 

154,118 

161,166 

4-57 

Aberdeen, 

124,943 

153,497 

22-85 

Paisley, 

66,425 

79,364 

19-48 

Leith, 

68,707 

77,438 

12-71 

Greenock, 

63,422 

68,115 

7-40 

Go  van. 

63,625 

76,351 

..      ^  20-00 

Partick, 

36,538 

54,274 

48-54 

GLASGOW, 

658,073 

761,712 

15-75 

England  and  Wales, 

12-17 

Scotland, 

11-09 

Institutional  Population  and  Shipping. 
For  the  purpose  of  the  Census  and  for  certain  sanitary  purposes,  the  per- 
sons residing  in  Institutions  and  on  board  ships  in  the  Harbour  and  Canals  are 
enumerated  and  dealt  with  separately.    At  the  enumeration  of  1891  and  1901 
these  were :  — 

Increase 

Census.         .  1891.  1901.  per  cent. 

Population  in  Institutions,   '     12,800  19,347  51-1 

Shipping,    750  1,241  65-5 


The  areas  of  some  of  those  towns  were  extended  in  the  decennium  of  1891-1901,  but  in  every  case 
the  population  in  1891  relates  to  the  town  as  constituted  in  1901. 


9 


The  following  quotation  from  the  Registrar- General's  instructions  to 
Registrars  will  indicate  tlie  reasons  which,  govern  the  inclusion  of  any  Institu- 
tion within  this  class. 

"13.  At  the  end  of  the  form  [for  plan  of  division]  you  will  insert  the 
name  of  every  public  institution  having  more  than  100  inmates,  and  the 
Governor  or  head  of  which  you  recommend  to  the  Registrar-General  to  be 
appointed  its  enumerator.  All  smaller  institutions  will  be  dealt  with  as 
ordinary  houses  in  the  enumeration  district  in  which  they  are  respectively 
situated." 

The  Institutional  population,  as  thus  defined,  shows  an  increase  of  6,547. 
The  inmates  of  Model  Lodging-houses  alone  would  appear  to  show  an  increase 
of  3,651,  but  the  records  in  the  present  Census  cover  26  Institutions  of  this 
class,  compared  with  13  at  the  Census  of  1891.  Some  of  these  now  added  existed 
in  1891,  but  were  then  dealt  with  as  houses.  In  addition,  certain  other 
Institutions  are  now  also  included  for  the  first  time,  and  these,  with  the  added 
Model  Lodging-houses,  are  marked  with  an  asterisk  in  the  subjoined  Table. 

The  only  valuable  comparison  therefore  which  can  be  made  is  between  the 
Model  Lodging-houses  of  which  there  is  a  record  at  both  periods,  and  in  them 
the  inmates  have  increased  from  4,160  to  4,737. 

Census  1901. —Glasgow — Table  showing  the  Number  op  Inmates  in  Institutions 

OP  Different  Kinds. 
Institution.  Inmates. 
Model  Lodging-Houses — 
Corporation  — 
Drygate, 

Greendyke  Street, 
Clyde  Street, 
JSTorth  Woodside  Road, 
Hydepark  Street, 
Portugal  Street, . . . 
Moncur  Street  (Females), 
*Family  Home,  ... 

Private — ■ 

*66  Moncur  Street, 

179  Great  Hamilton  Street, 
*173  High  Street, 
*195  High  Street, 
*34  Stirling  Street, 
*48  Duke  Street,... 

39  Watson  Street, 

21  Watson  Street, 

14  Watson  Street, 
*6-14  Miller's  Place, 

28  M'Alpine  Street, 
*22  James  Watt  Street, 
*1  Burns  Street,  ... 
*16  Garscube  Lane, 
*(Clydesdale),  Hydepark  Street, 
*(Carlton),  Buchan  Street, 

(Kingston),  Centre  Street, 
*Maryhill,   


2,802 


369 
286 
369 
358 
349 
429 
267 
375 

193 
700 
170 
146 
195 
207 
352 
520 
111 
114 
316 
379 
401 
255 
134 
403 
311 
102 
 5,009 


7,811 


Carry  fonvard, 


7,811 


Included  as  Institutions  for  the  fir.st  time  in  1901. 


10 


Institution.  Inmates. 

Brought  forward,      ...        ...  7,811 

Hotels  (4  in  number),     ...        ...        ...        ...        ...        ...        ...  615' 

Royal  Infirmary,  .. .        ...        ...        ...        ...        ...        ...        ...  738 

Western  Infirmary,  635 
Victoria  Infirmary,         ...        ...        ...        ...        ...        ...        ...  218 

Eye  Infirmary,     ...        ...        ...        ...        ...        ...        ...        ...  Ill 

Royal  Hospital  for  Sick  Children,        ...        ...        ...        ...        ...  114 

Eastpark  Home,   109 

Royal  Lunatic  Asylum,  Gartnavel,      ...        ...        ...        ...        ...  556 

*City  Fever  Hospital,  Parliamentary  Road,      ...        ...        ...        ...  298 

Do.  Belvidere,  . . .        ...        ...        ...        ...        ...  689 

*  Do.  Ruchill,   766 

*City  Reception-House,  South  York  Street,      ...        ...        ...        ...  102 

;  4,336 

Slatefield  Industrial  School,      ...        ...        ...        ...        ...        ...  177 

St.  Mary's  do.  (Boys),    210 

Do.  do.  (Girls),    208 

MaryhiU  do.  (Girls),    200 

 795 

Central  Police  Office,    130 

H.M.  Prison,  Duke  Street,      419 

  549' 

241 
201 
123 
254 
87 
102 
1,667 
1,431 
142 
160 
132 
701 

 5,241 

Total  within  Municipal  Boundaries,         ...        ...  19,347 


St.  Joseph's  Home,  Garngadhill, 
*Homes  for  Old  Men  and  Old  Women,  Rottenrow, 
*City  Orphan  Home,  James  Morrison  Street,  ... 

Night  Asylum  for  the  Houseless, 
*Mission  Hall  for  Friendless  Females,  ... 

Magdalene  Institution,  MaryhiU, 

City  Poorhouse,  ... 

Barnhill  Poorhouse, 

Deaf  and  Dumb  Institution,  Langside, ... 
*Roman  Catholic  Training  College,  Dowanhill, . . . 
*01d  Barracks  Show  Ground,  Gallowgate, 

Government  Military  Barracks,  MaryhiU, 


Shipping. 

The  number  of  persons  resident  on  board  ships  in  the  Harbour  and  Canals 
increased  from  750  in  1891  to  1,241  in  1901.  Formerly  the  number  of  persons 
thus  returned  maintained  a  fair  degree  of  constancy,  the  figures  for  each 
Census,  1861-1891,  being  639,  569,  590,  and  750  respectively. 

As  the  quayage  within  the  Municipality  has  not  increased  during  the 
decade,  the  increase  in  the  Harbour  population  is  most  likely  related  to  some 
alteration  in  the  manning  of  large  steamships  by  Lascar  and  Chinese  crew^s,  who 
live  on  board  while  the  vessels  are  in  port — the  proportion  resident  on  board  those 
in  the  Canals  being  so  small  that  it  may  be  discarded.  Regarding  this  Mr.  T.  R. 
Mackenzie  writes : — 

"  I  have  made  some  inquiry  into  the  matter  you  refer  to,  and  think  there  can  be  no 
doubt  that  the  explanation  you  suggest  is  the  true  one  for  the  abnormal  increase  in  the 
number  of  persons  living  on  board  ship,  as  shown  by  last  Census. 

"  When  the  previous  Census  was  taken  the  Anchor  Line's  eastern  vessels,  and  the 
Clan  Line,  had  only  partially  introduced  coloured  crews,  now  their  employment  of 
Lascars  is  greatly  extended,  while  the  City  Line  and  Messrs.  P.  Henderson  k  Co. 
have  also  manned  their  vessels  in  the  same  way." 


*  Included  as  Institutions  for  the  first  time  in  1901. 


11 

The  extent  of  quayage  is  given  in  1891  as  10,920  lineal  yards,  but  this  does 
not  distinguish  between  the  Docks  of  Glasgow,  Govan,  and  Partick,  and  I  am 
indebted  to  Mr.  Mackenzie  for  the  following  measurements  as  at  30th  June,  1901:— 

Clyde  Navigation. 
Length  of  Quays  (including  ferry  stairs,  &c.)  as  at  30th  June,  1901  :— 

City  or  Glasgow. 

Lin.  Yards.      Lin.  Yards. 
501| 

4,911 

830 

3,334 

  9,576| 

BUBGH  OF  GoVAN. 


Glasgow  Lower  Harbour,   ...  ...  ...  1,373|^ 

Prince's  Dock,     ...  ...  ...  ...  3,737 

  5,1101 

Govan  Passenger  Wharf,    ...  ...  ...  ...  46f 

Shieldhall  Old  and  New  Wharves,    ...  ...  ...  381i 


Total  Lineal  Yards,    ...  15,115 


Age  and  Sex  Distribution. 

At  each  enumeration  since  1861  the  proportion  of  males  to  females  in  the 
population  has  increased,  a  circumstance  which  would  appear  to  be  related  to 
some  alteration  in  industrial  conditions  resulting  in  a  relative  increase  of  the 
opportunities  for  male  employment.  Since  1851  the  proportion  of  males  to  every 
100  females  has  been  as  follows  :  — 

1851,        ...        89'0  1881,        ...  94'5 

1861,        ...        88-5  1891,*      _  94-6 

1871,        ...       94-0  1901,       ...  96-2 

1901.— Scotland,  94-5.  England  and  Wales,  93-5. 


Glasgow  Upper  Harbour,  ... 

,,      Lower  Harbour,  ... 
Kingston  Dock,  ^ 
Queen's  Dock, 


Numbers  of  each  Sex  living  at  various  Age  Periods. — Age  and  Sex 

Distribution. 

In  the  following  Table  the  number  of  each  sex  living  at  certain  age 
periods  is  given  for  the  whole  City. 

Table  II.  in  the  Appendix  contains  the  number  of  each  sex  living  in  each  of 
the  Sanitary  Districts  at  corresponding  age  periods,  and  in  Table  V.  these  are 
stated  as  a  percentage  of  the  total  living  at  all  ages. 

*  Greater  Glasgow, 


12 


Glasgow — Census  1901. — Age  and  Sex  Distribution. 


Age. 

JMales. 

jj  rjiViAi-iJliO. 

Under  1  year,  ... 

10,423 

10,243 

20,666 

1-5  years,  ... 

34,908 

35,251 

70,159 

5-10  „   

40,156 

39,665 

79,821 

10-15  „   

37,049 

37,617 

74,666 

15-20  ,  

37,670 

39,136 

76,806 

20-25  „   

40,955 

42,364 

83,319 

25-35  „ 

DO,  /  DO 

D / ,3  J  9 

ioo,Uo  t 

35-45  „   

46,605 

47,729 

94,334 

45-55  „   

32,356 

33,029 

65,385 

55-65  „   

18,351 

21,638 

39,989 

65        ,,    and  upwards, 

9,244 

14,128 

23,372 

Not  known, 

50 

58 

108 

All  Ages,  ... 

373,535 

388,177 

761,712 

1891,  All  Ages,   

319,909 

338,164 

658,073 

Compared  with  1891  this  shows  a  numerical  increase  of  53,526  males  and 
50,013  females,  representing  a  rate  of  16"7  per  cent,  for  males  and  14"5  for 
females.  In  Scotland,  as  a  whole,  males  increased  by  11  "8  per  cent,  during  the 
decennium,  and  females  by  10"37  per  cent.,  while  in  England  and  Wales  the 
increase  of  females  exceeded  that  of  males,  the  rates  being  12'4  and  11*9  per 
cent,  respectively. 

Before  we  can  compare  the  sources  of  increase  in  each  sex,  we  must  fall 
back  upon  the  assumption  already  referred  to  in  dealing  with  the  population  as 
a  whole,  and  supply  for  the  period  from  1st  April  to  31st  December,  1891,  a 
number  which  will  represent  the  rate  which  obtained  in  remainder  of  the  decade. 

Glasgow. — -Natural  Increase  by  Excess  of  Births  over  Deaths  during 
THE  Period  from  1st  January,  1892,  to  31st  March,  1901.* 


The  births  and  deaths  registered  during  the  37  quarters  of  the  decennium 
ending  31st  March,  1901,  were  as  follows  : — 


Births. 

Deaths. 

Excess  of  Births. 

Males,  

111,270 

73,222 

38,048 

Females, 

106,999 

69,752 

37,247 

Both  Sexes, 

218,269 

142,974 

75,295 

*  The  Births  are  taken  throughout  from  the  Registrar-General's  Mouthly  Reports. 
The  Deaths  are  from  the  Registrar-General's  detailed  Reports  from  1S92  to  1899,  and  from  the 
Monthly  Reports  for  1900  and  the  first  quarter  of  1901. 


13 

t  We  can  now,  after  adding  the  estimated  births  and  deaths  in  the  last  three 
quarters  of  1891,  use  these  figures  to  build  up  a  Table  which  will  show  the  balance 
of  increase  resulting  from  the  excess  of  immigration  over  emigration. 


Males. 

Females. 

Census,  1891,   

319,909 

338,164 

Births  minus  Deaths,  April,  1891,  to  April,  1901, 

41,137 

40,268 

Population,  1901,  by  natural  increment, 

361,046 

378,432 

.,           ,,        as  enumerated, 

373,535 

388,177 

Difference — being  gain  by  excess  of  arrivals  over 

departures. 

12,489 

9,745 

The  natural  increment  of  males  constitutes  76-7  per  cent,  of  the  total 
increase,  that  of  females,  80-5  per  cent.,  so  that  the  proportion  of  males  added  by 
immigration  is  greater  than  females.  There  is  a  balance  of  influx  equal  to  2,223 
persons  annually,  of  whom  1,249  are  males  and  974  are  females. 


Proportion  of  Males  and  Females  living  at  several  Age  Periods  in 

EVERT  100,000  OF  EACH  SeX  IN  1891  AND  1901  COMPARED. 


1901. 

1891. 

Age. 

Males. 

Females. 

Males. 

Females. 

12,136 

11,722 

0-  5  years. 

13,051 

12,332 

10,752 

10,220 

5-10  ., 

11,531 

10,788 

9,920 

9,692 

10-15  „ 

10,635 

10,192 

10,086 

10,083 

15-20  „ 

10,249 

10,247 

10,966 

10,915 

20-25  „ 

10,378 

10,098 

17,609 

17,345 

25-35  „ 

16,666 

16,640 

12,479 

12,298 

35-45  „ 

12,166 

11,642 

8,663 

8,510 

45-55  ,, 

8,348 

8,855 

4,914 

5,575 

55-65  „ 

4,548 

5,479 

2,475 

3,640 

65  and  upwards, 

2,428 

3,727 

100,000 

100,000 

All  Ages, 

100,000 

100,000 

This  Table  enables  us  to  compare  the  age  constitution  of  the  population 
in  1891  and  1901,  and  the  comparison  is  not  without  significance.  At  all 
ages  under  20  there  are  now  relatively  fewer  persons  of  each  sex  living  than  in 
1891,  and  the  converse  holds  true  for  each  age  period  above  this,  save  for  females 
at  ages  45-55,  and  again  over  65.  The  factors  contributing  to  this  are  a  falling 
birthrate  and  an  influx  of  immigrants,  who  are  usually  young  adults.  We  are 
thus,  as  a  population,  becoming  older  in  the  literal  sense  to  which  the  phrase 
is  applicable  to  the  individual,  and  an  extension  of  the  comparison  will  help 
to  gauge  the  extent  of  this. 


14 


Without  any  serious  error  this  comparison  may  be  carried  back  to  1881^ 
hearing  in  mind  the  extension  of  the  area  in  1891.  The  Umited  influence  of  this, 
however,  on  the  age  distribution,  is  indicated  by  the  proportions  living  at  ages 
0-25  and  25-65  in  1891,  forming  almost  a  middle  term  to  those  in  1881  and  1901. 


Proportion  per  cent,  of  the  Population  Living  at  various  Age  Periods 
IN  Three  Successive  Census  Enumerations. 


Age. 

1881. 

1891. 

1901. 

0-5  

13-70^ 

12-68^ 

11-92^ 

5-10  

10-15  

15-20  

1M2 
9-76 
10-28 

.  ^ 
>o 

11-15 
10-41 
10-25 

-* 

10-48 
9-81 
10-08 

cr> 

■ 

cc 

20-25   

10-56  J 

10-23. 

1094. 

25-35   

16-39' 

16-65^ 

17-47' 

35-45   

45-55   

11-95 
8-30 

o 

11-90 
8-61 

Oi 

- 

12-39 
8-59 

o 
eo 

55-65   

5-06, 

5-03. 

5-25. 

65  and  upwards, 

2-88 

3-09 

3-07 

Taking  the  ages  25-65  as  representing  the  period  of  maturity,  the  proportion 
of  the  population  living  therein  has  increased  in  20  years  from  41-7  to  43-7  per 
cent.,  while  the  proportion  of  the  population  at  ages  0-25  has  fallen  from  55-4 
to  53-2  per  cent.  Although  the  adult  ages  contain  the  most  actively  productive 
period  of  life,  there  are  fewer  recruits  coming  forward  to  fill  their  places. 


Irish  Born. 

Per  Cent,  of 
Total  Population. 


1851,    60,058    18 

1861,    63,574    15-8 

1871,    70,410    14-4 

1881,    65,185    13 

1891,    57,618    10-2 

1901*    66,106    8-7 


HOUSING. 

The  inhabited  houses  numbered  155,404,  compared  with  134,882  at  last 
Census,  an  increase  of  20,522,  or  15-2  per  cent.  In  addition,  7,274  were  found 
empty,  compared  with  6,663  at  the  Census  of  1891.  The  inhabited  houses  con- 
tained 401,543  windowed  rooms,  and  were  occupied  by  741,124  persons,  the 
balance  of  the  population  being  distributed  among  Institutions  and  Shipping, 
as  formerly  described. 

Were  the  houses  of  equal  size,  each  would  contain  2-584  rooms,  and  were 
the  population  equally  distributed  among  them,  each  house  would  contain  4-769 


*  Greater  Glasgow. 


15 

persons,  and  each  room  1-846.  This  affords  a  convenient  way  of  expressing 
the  size  of  an  average  house  and  the  average  number  of  persons  inhabiting  it, 
but  it  lacks  the  advantage  of  conveying  information  regarding  the  average  size 
of  the  rooms.  Obviously,  also,  it  is  only  relatively  applicable  to  existing  con- 
ditions, and  later,  when  considering  the  occupancy  of  one  and  two  apartment 
houses,  we  shall  see  how  widely  it  is  departed  from.  But  it  enables  a  com- 
parison to  be  established  between  the  average  size  and  the  average  occupancy 
of  houses  in  this  and  former  decades,  and  between  the  average  conditions  in 
this  respect  existing  in  Glasgow  and  other  towns.  It  affords  evidence  that  the 
average  house  is  undergoing  a  gradual  enlargement  in  size,  and  the  ocGU])ants 
per  room  a  gradual  reduction  in  number. 

To  obtain,  however,  any  clear  estimate  of  the  changes  which  have  taken 
place  during  the  decade  in  the  character  of  the  housing  accommodation,  it  will 
be  necessary  to  keep  in  view  the  area  of  the  City  before  and  after  the  extension  of 
1891.  This  is  owing  to  the  character  of  the  average  house  in  the  added  districts. 
It  had  a  greater  average  number  of  inmates,  but  fewer  in  relation  to  the  number  of 
occupied  rooms.  In  Old  Glasgow,  at  the  1891  Census,  the  average  house  had  2-325 
rooms  and  contained  4-727  persons,  or  2-033  per  room ;  in  the  added  area  it  had 
4'167  rooms,  and  was  occupied  by  5-128  persons,  but  it  had  only  1-230  inmates  per 
room ;  in  both  together  it  contained  2-562  rooms  and  4-778  persons,  but  the  average 
number  of  persons  per  room  was  reduced  to  I'SGS.  With  this  explanation  we  can  now 
compare  corresponding  details  for  three  Censuses :  — 


Rooms  per  House. 

Persons  per  House. 

Persons  per  Room. 

1881,   

2-322 

4-738 

2-040 

1891  (Old  Glasgow),   

2-325 

4-727 

2-033 

Added  Districts,... 

4-167 

5-128 

1-230 

Whole  Area, 

2-562 

4-778 

1-865 

1901,   

2-584 

4-769 

1-846 

The  removal  of  the  decimal  point  will  facilitate  the  reading  of  these 
figures,  so  that  they  may  be  taken  as  whole  numbers  applicable  to  1,000  houses 
of  average  size.  These  now  contain  22  rooms  more  than  a  similar  number  of 
houses  in  1891,  which  may  also  be  expressed  in  this  form :  that  1,000  houses  of 
the  present  average  size  are  the  equivalent  of  1,008  6  houses  in  1891. 

The  indication  which  this  affords  of  a  gradual  upward  tendency  in  the 
standard  of  house  accommodation  accords  with  experience  elsewhere  in  Scot- 
land. In  the  following  Table,  Edinburgh  and  Dundee  alone  show  a  continuous 
reduction  in  the  size  of  the  average  house  during  three  decades,  but  in  all 
the  towns  quoted  for  which  the  information  is  available  for  more  than  one 
Census,  there  is  a  reduction  in  the  average  number  of  inhabitants  per  room, 
which  is  the  most  important  sanitary  factor  in  the  question  of  housing. 

In  Edinburgh,  Aberdeen,  and  Perth  the  size  of  the  average  house 
exceeds  the  average  for  Scotland,  and  they  have  also  fewer  persons  per  room. 
In  Dundee,  Paisley,  and  Govan  it  is  smaller  than  in  Glasgow ;  in  Paisley  and 
Govan  the  number  of  persons  per  room  is  greater. 


16 


Census,  1901. — Table  showing  the  Average  Number  of  Rooms  per 
Inhabited  House,  and  of  Persons  per  Room  (including  Institutions), 
IN  certain  Towns  and  Burghs  of  Scotland,  at  the  Censuses  of 
1881,  1891,  AND  1901.* 


Rooms  per  Inhabited  House. 

Persons  per  Room. 

188L 

189L 

1901. 

1881. 

1891. 

1901. 

Glasgow,  ... 

2-34 

2-34 

2-054 

2-054 

Greater  Glasgow,  ... 

2-59 

2-62 

1-884 

1-868 

Edinburgh, 

4-19 

4'16 

3-93 

1-320 

1-231 

1-221 

Dundee, 

2-85 

2-62 

2-50 

1-870 

1-842 

1-752 

Aberdeen,  ... 

3-42 

3-22 

3 '27 

1-511 

1-437 

1-405 

Greenock,  ... 

2-64 

2-71 

2-74 

1-907 

1-823 

1-796 

Leith, 

2-98 

3-06 

3'07 

1-671 

1-608 

1-567 

Paisley, 

2-42 

2-47 

2-50 

1-984 

1-969 

1-948 

Perth,   

4-96 

3-86 

3-87 

1-312 

1-233 

1-174 

Kilmarnock, 

2-59 

2-63 

1-876 

1-829 

Go  van. 

2-26 

2-191 

Partick, 

2-95 

1-630 

Scotland,  .... 

3-21 

3-20 

3-26 

1-60 

1-55 

1-48 

Grouping  of  the  Population  in  Houses  op  various  Sizes. 

The  following  Tables  illustrate  the  widely- varying  conditions  under  which  the 
population  is  housed.  Attention  will  chiefly  be  directed  to  the  proportion  of 
houses  of  one  and  two  apartments,  which  together  form  67  per  cent,  of  the 
total  houses,  and  accommodate  61  per  cent,  of  the  population : — 


Glasgow.  —  Census  1901. 

Inhabited 

Population. 

Persons. 

Houses. 

Per  House. 

Per  Room. 

1  Apartment,  ... 

32,709 

104,128 

3-183 

3-183 

2  Apartments,  ... 

70,784 

348,731 

4-927 

2-463 

3  Apartments,  ... 

28,055 

151,754 

5-409 

1-803 

4  Apartments,  ... 

10,933 

58,272 

5-330 

1-332 

5  Apartments  and  upwards. 

12,923 

78,239 

6-054 

1-270 

155,404 

741,124 

4-769 

1-846 

*  As  the  population  of  Institutions  cannot  be  excluded  in  the  case  of  the  other  towns,  it  has  been 
necessary  to  deal  with  the  whole  population  of  Glasgow  in  this  calculation,  which  accounts  for  the 
slight  difference  between  the  figures  given  here  and  elsewhere. 


17 


Peoportion  per  cent,  of  Houses  of  Certain  Sizes,  and  Proportion  per 
CENT.  OF  Population  inhabiting  them  in  1891  and  1901  compared. 
These  proportions  can  be  accurately  stated  for  the  area  as  existing  at  the 

Census  of  1891  and  at  that  of  1 901,  but  they  are  only  comparable  within  the  limits 

afterwards  described. 


Sizes  of  Houses. 

Percentage  of  Houses  of  Different 
Sizes. 

Percentage  of  Population  occupy- 
ing each  Class. 

1891. 

1901. 

1901. 

1891. 

1901. 

1901. 

1  apartment, 

(1) 
26  40 

(2) 
23-80 

(3) 
21-05 

(4) 
18-051 

(5) 
15-89 

(6) 
14-050 

2  apartments, 

45-34 

47-93 

45-55 

47-482 

49-95 

47-054 

3 

16-85 

17-52 

18-05 

19-668 

20-49 

20-476 

6-05 

5-77 

7-03 

7-204 

6-86 

7-863 

5         ,,  and  upwards, 

5-36 

4-98 

8-32 

7-595 

6-81 

10-557 

Columns  1,  2,  4,  and  5  of  the  above  Table  apply  to  the  area  of  the  City  at 
the  Census  of  1891,  while  columns  3  and  6  apply  to  the  present  area.  The 
data  for  the  corresponding  calculation  for  the  whole  of  the  added  districts  at 
1891  do  not  exist,  but  columns  2  and  5  have  been  calculated  to  show  the  changes 
which  had  taken  place  in  1901  within  the  area  of  the  1891  Census.  They  are^ 
therefore,  comparable  with  columns  1  and  4. 

One-Apartment  Houses. — In  1891,  26-4  per  cent,  of  the  houses  were  of  one 
apartment,  and  18  per  cent,  of  the  population  lived  in  them.  In  1901  these 
proportions  were  21  and  14  per  cent,  respectively,  but  when  the  comparison  is 
confined  to  the  area  of  Old  Glasgow,  the  reduction  is  only  to  23-8  per  cent,  for 
houses  and  to  15:9  per  cent,  for  population. 

Two-Apartment  Houses. — The  proportion  of  houses  of  this  class  is  little 
altered  when  the  old  and  new  areas  are  compared,  while  the  proportion  of  popula- 
tion inhabiting  them  is  Only  slightly  lowered  in  the  latter.  Now,  as  formerly, 
therefore,  almost  one-half  the  population  live  in  houses  of  two  apartments.  But 
within  the  older  area  the  proportion  of  such  houses  has  inci-eased  by  2-59  per  cent., 
and  the  proportion  of  population  in  them  by  2-47  per  cent. 

Taking  houses  of  one  and  two  apartments  together,  they  now  form  66'6  per 
cent,  of  the  total  inhabited  houses,  compared  with  71-7  per  cent,  in  1891, 
and  are  now  inhabited  by  61  per  cent,  of  the  population,  instead  of  65-5  in  1891 ; 
but,  confining  the  comparison  to  the  limits  of  the  old  area,  the  proportion  in  both 
cases  is  practically  maintained,  being  71-74  against  71-73  for  houses,  and  65-53 
against  65-84  for  population. 

Reduction  in  One-apartment  Houses. 

This  constancy  in  the  proportion  of  houses  of  both  sizes  within  this  area  has, 
as  we  have  seen,  been  accompanied  by  a  change  in  the  relative  proportion  of  each, 
so  that  the  actual  change  which  has  taken  place  must  be  further  examined  on  the 
basis  of  the  numbers  existing  at  each  Census. 

There  were  31,032  houses  of  one  apartment  at  the  Census  of  1891.  At  the 
present  Census  they  numbered  32,709,  but  2,273  of  these  are  in  the  added 


\ 


18 


districts — 1,779  being  in' the  districts  of  Maryhill  (30)  and  Possilpark  and  Barn- 
liill  (31)  alone — leaving  30,436  for  the  old  area.  The  reduction  ^n  the  propor- 
tion of  one-apartment  houses  in  Old  Glasgow,  therefore,  has  been  accompanied  by 
an  actual  reduction  of  their  number  by  596. 


Old  Glasgow. — One-Apartment  Houses,  1891  and  1901,  Compared. 


Houses. 

Population. 

Proportion  of 
Houses  of  all 
Sizes. 

Proportion  of 
Population 
Occupying. 

Persona  per 
Eoom. 

189L   

31,032 

100,298 

26-40 

18-05 

3-232 

1901,   

30,436 

96,586 

23-80 

15-89 

3.173 

Decrease,  ... 

596 

3,712 

2-60 

2-16 

-059 

Added  Districts,  1901, 

2,273 

7,542 

9-0 

5-7 

3-318 

Coincident  with  this  reduction  in  the  number  of  houses  of  this  size  within 
the  older  area,  the  population  inhabiting  them  has  been  reduced  by  3,712  and 
the  average  number  of  persons  per  room  from  3-282  to  3'173.  This  latter  figure 
is  to  be  compared  with  3'183,  which  is  the  average  occupancy  of  all  one-apartment 
houses,  and  brings  into  contrast  the  relatively  greater  average  number  of  occupants 
of  one-apartment  houses  in  the  suburbs,  which  is  3-318  per  house. 

This  had  been  observed  in  1891  as  applicable  to  houses  of  one  and  two 
apartments  in  the  landward  portions  of  the  Glasgow  Registration  Districts* 
(Dennistoun,  St.  Rollox,  Hutchesontown,  Gorbals,  Tradeston,  and  Kinning  Park), 
which  were  then  already  otherwise  partly  urban,  while  in  three  and  four  apartment 
houses  the  reverse  was  the  case,  and  the  figures  are  repeated  in  the  following 
Table  for  convenient  reference : — 


Average  Number  of  Inmates  per  Room  in  Old  Glasgow  and  Added 
Districts,  and  in  Greater  Glasgow. 


1  Apartment. 

2  Apartments. 

3  Apartments. 

4  Apartments. 

1891,  Old  Glasgow, 

3-23 

2-47 

1-84 

1-41 

Landward      Portions  of 
Registration  Districts, 

3-58 

2-60 

1-74 

1-19 

1901,  Glasgow,   

3-18 

2-46 

1-80 

1-33 

Old  Glasgow, 

3-17 

2-48 

1-85 

141 

Added  Districts, 

3-32 

2-38 

1-61 

1-17 

We  shall  have  an  opportunity  further  on  of  considering  the  actual  change 

which  has  taken  place  during  the  decade  in  the  number  of  one-apartment  houses 

in  the  several  Sanitary  Districts  within  Old  Glasgow ;  but,  as  representing  in  a 

minor  degree  the  change  in  social  conditions  which  an  increase  in  houses  of  this 

size  indicates,  the  following  Table  shows  those  districts  in  which  the  proportion  of 

houses  of  this  size  is  now  greater  than  in  1891 : — 

*  Along  with  these  are  included  the  figures  for  the  Burghs  of  Hillhead  and  Maryhill  and  the 
District  of  Kelvinside. 


19 


DiSTKicTS  OF  Old  Glasgow  in  which  the  Proportion  of  One-Apartment 

Houses  has  Increased. 


No.  of  1  apartment  Houses. 

Inhabitants. 

1891. 

1901. 

1891. 

1001. 

•"> 

Port-Dundas, 

254 

332 

813 

1,019 

9. 

Monteith  Row,  ... 

174 

172 

524 

542 

i;5. 

Brownfield, 

128 

135 

356 

409 

17. 

Kelvinhaugh   and  Sandy- 
ford, 

359 

392 

1,063 

1,119 

Monteith  Row  has  been  included  here,  although  there  is  a  reduction  of 
two  in  the  number  of  such  houses.  The  total  number  of  houses  of  all  sizes  in 
this  district  has,  however,  decreased,  but  to  a  greater  extent,  so  that  the  proportion 
of  houses  of  one  apartment  is  now  greater  than  it  was  ten  years  ago. 


Sub-divided  Houses. 
There  is  some  reason  for  thinking  that  were  the  condition  of  individual 
occupancies  accurately  known,  some  portion  at  least  of  the  houses  which  we  have 
just  been  considering  as  of  two  or  more  apartments  would  be  transferred  to  the  list 
of  one-apartment  houses,  and  each  room  regarded  as  separately  occupied.  This 
consideration  does  not  alfect  the  comparison  with  former  years,  but  it  should  be 
borne  in  mind. 

A  house,  as  defined  for  Census  purposes,  has  certain  limitations.  It  must 
have — 

(1)  A  distinct  outside  entrance  from  a  street,  court,  lane,  road,  &c.,  or 

(2)  A  door  opening  directly  into  a  common  stair  or  passage ;  hut  any  such 
dwelling  if  subdivided  and  occupied  by  different  families  is  to  be  reckoned  as 
one  house. 

From  this  definition,  it  is  obvious  that  the  primary  conception  of  a  house 
for  Census  purposes  may,  in  respect  of  the  latter  qualification,  fail  to  convey 
its  significance  as  a  sanitary  factor,  and,  indeed,  in  the  final  Reports  of  former 
Censuses  the  Registrar-General  has  been  in  the  habit  of  regarding  the  number 
of  families  as  the  index  of  the  number  of  houses.  For  the  present  we  must 
deal  with  thera  as  now  defined. 

We  have  already  seen  that  the  total  number  of  inhabited  houses  is  155,404. 
In  his  preliminary  Report  on  the  present  Census  the  Registrar-General  gives 
the  number  of  "  families  "  as  163,422,  so  that  the  '■  fomilies  "  exceed  the  houses  by 
8,018.  What  does  this  disparity  cover  ?  As  here  used,  however,  the  term  "  family  " 
has  a  restricted  and  purely  conventional  meaning,  which  we  need  only  for  the 
present  consider  in  so  far  as  it  relates  to  the  separate  occupancy  of  rooms  in  the 
subdivided  houses  referred  to  in  the  definition  just  quoted. 

A  common  illustration  is  afforded  by  a  two-apartment  house,  where  each 
apartment  is  entered  separately  from  a  common  lobby  and  occupied  by  a  separate 
family.  Some  semblance  of  privacy  is  still  possible  to  the  several  occupants, 
although  the  water  supply  for  both  is  at  the  kitchen  sink ;  but  where  the  room  or 
second  apartment  is  only  reached  through  the  kitchen,  independent  family  life 


20 


becomes  impossible.  The  house  and  its  appurtenances,  originally  designed  for  the 
requirements  of  one  family,  are  now  shared  by  two,  and  each  apartment  becomes  a 
one-roomed  house  under  the  worst  possible  conditions.  We  know  that  this  noo 
infrequently  occurs  in  several  houses  in  one  tenement  under  fluctuating  conditions 
of  occupancy.  The  farmed-out  house  is  largely  of  this  class.  In  January 
of  this  year  (1902),  859  such  were  on  the  register;  531  of  these  were  classed 
as  single-apartment  houses,  the  remaining  328  were  houses  varying  in  size 
from  2  to  9*  apartments.  These  latter  contained  741  rooms,  which,  added  to  the 
531  properly  regarded  as  single  apartments,  gives  a  total  of  1,272  rooms  used 
mostly  as  single  apartments,  and  not  necessarily  restricted  in  their  occupancy  even 
to  separate  families  until  Section  17  of  the  Provisional  Order  of  1901  came  into 
operation  this  year. 

The  following  Table  shows  the  number  of  farmed-out  houses  in  each  sanitary 
district,  with  the  number  of  each  of  various  sizes,  as  known  in  January,  1892  :  — 


Farmed-out  Houses. 


Sanitary 
Sub- 

T)l  VI <51  r>Tl  Q 
-L/1  V  ioHJllb. 

1 

Apt. 

2 

Apts. 

3 

Apts. 

4 

Apts. 

5 

Apts. 

6 

Apts. 

7 

Apts. 

9 

Apts. 

Total. 

Apart- 
ments. 

Percentage 
of  Farmed- 
out  Houses 

Houses. 

1. 

8 

3 

11 

28 

•3 

3. 

27 

6 

2 

1 

1 

37 

56 

2-0 

4. 

32 

32 

32 

1-0 

5. 

62 

19 

5 

2 

88 

123 

0-5 

6. 

26 

26 

2 

54 

84 

4'9 

8. 

10 

4 

14 

18 

0-2 

9. 

13 

13 

5 

2 

1 

1 

35 

82 

4-2 

10. 

6 

7 

1 

1 

15 

28 

2-0 

11. 

143 

50 

9 

2 

204 

278 

4-4 

12. 

4 

4 

8 

12 

1-8 

13. 

37 

33 

4 

74 

115 

10-8 

14. 

37 

30 

2 

2 

71 

111 

9-2 

16. 

46 

5 

51 

56 

1-3 

18. 

58 

31 

3 

92 

129 

1-6 

19. 

1 

1 

2 

3 

0  0 

20. 

4 

4 

4 

0-2 

21. 

1 

14 

2 

17 

35 

0-1 

22. 

24 

24 

2 

50 

78 

2-0 

Total, 

531 

275 

37 

9 

2 

3 

1 

1 

859 

1.272 

*  The  inclusion  of  houses  having  more  than  two  rooms  among  farmed-out  houses  is  a  sanitary 
necessity,  but  it  has  not  at  present  legal  sanction  {vide  Public  Health  Act,  Section  72  (2)  ). 


21 

The  growth  of  the  farmed-out  house  needs  the  laiost  constant  watchfulness 
and  it  is  a  matter  for  consideration  whether  an  annual  census  of  its  occupants 
would  not  well  repay  the  trouble  and  cost  involved. 

Its  existence  had  no  legal  recognition  until  the  passing  of  the  Public 
Health  (Scotland)  Act,  1897,  but  its  evolution  from  the  class  of  "  Houses  Let  in 
Lodgings  "  began  prior  to  this.  Its  occupant  falls  short  of  the  standard  by 
which  the  caretaker  or  house-factor  estimates  the  desirable  tenant.  Yet  his 
rent-paying  power  is  considerable.  £13  annually  represents  the  sum  of  the 
weekly  payments  for  a  single  room  so  occupied,  only  £2  less  than  the  average 
rent  of  a  three-apartment  house.  The  attraction  to  the  occupant  is  that  he 
need  produce  ho  evidence  of  former  regularity  in  rent-paying ;  that  it  now  may  be 
paid  in  nightly  doles  of  lOd.,  or  5s.  per  week,  for  which  also  he  has  the  use 
of  certain  domestic  furnishings  in  their  simplest  form.  The  solatium  to  the 
house-farmer  for  occasional  loss  from  unlet  rooms  or  destruction  of  furnishings 
is  the  return  of  20s.  per  four  weeks  from  premises  which  he  leases  at  something 
between  6s.  and  8s.  a  month. 

There  is  another  point  of  view,  however,  from  which  these  houses  may  be  con- 
sidered. The  present  legal  standard  of  air-space  per  adult  in  these  and  other  smaller- 
sized  houses  in  private  occupancy  is  400  cubic  feet,  and  this  is  applicable  also  to 
the  dormitories  of  Common  Lodging-houses,  which  are  under  regulation  as  to 
ventilation  and  cleanliness.  But  the  400  cubic  feet  of  a  Common  Lodging- 
house  is  reserved  exclusively  for  sleeping  purposes,  while  the  corresponding 
space  in  the  private  house  is  in  constant  occupancy,  and  is  used  both  for  living 
and  sleeping  purposes.  The  value,  therefore,  to  the  inhabitant  of  each,  of  the 
legal  allowance  of  air-space  at  his  disposal  must  be  appraised  by  a  different 
standard,  if  indeed,  they  are  to  be  regarded  as  at  all  comparable,  which,  in  fact, 
they  are  not.  The  balance  is  against  the  occupant  of  the  smaller  dwelling,  the 
air  of  which,  under  conditions  of  almost  continuous  occupancy,  can  rarely  be 
rendered  pure. 

Question  of  Overcrowding. 

We  have  already  seen  that  14  per  cent,  of  the  population  are  living  in  houses 
of  one  apartment,  with  an  average  occupancy  of  more  than  three  persons  per  room, 
and  that  47  per  cent,  of  the  population  are  living  in  houses  of  two  apartments,  with 
an  average  occupancy  per  room  of  almost  2'5  persons.  Both  figures  are  in  excess 
of  the  average  room-density,  and,  as  this  affects  61  per  cent,  of  the  population, 
some  effort  is  requisite  to  discover  what  it  implies. 

In  considering  the  question  of  overcrowding  in  England  and  Wales  at 
the  Census  of  1891,  the  Registrar- General  adopted  the  standard  of  two  persons 
per  room  as  representing  the  limit  of  reasonable  occupancy,  and  regarded  any 
excess  over  this  in  houses  of  less  than  five  rooms  as  indicating,  save  in  exceptional 
circumstances,  the  degree  of  overci'owding  which  existed.  On  this  basis  most  of 
the  recent  enquiries  into  overcrowding  in  English  cities  has  proceeded,  and  a 
comparison  *  has  lately  been  established  in  which  the  figure  which  represents 
the  proportion  of  the  Glasgow  population  living  more  than  two  in  a  room  is  used 
to  indicate  a  comparable  condition. 


*  "Poverty:  A  Study  of  Town  Life, "  p.  171.  By  B.  Seebohm  Rowntree.  London  :  Macmillan 
&  Co.,  Ltd.,  1901. 


The  method  here  adopted  proceeds  by  excluding  the  proportion  of  one,  two, 
three,  and  four-apartment  houses,  in  which  the  persons  resident  do  not  exceed  twice 
the  number  of  apartments  in  each  size  of  house,  and  calculating  the  number  living 
in  excess  of  this  as  a  percentage  of  the  total  population.  .Corresponding  detail 
is  not  yet  available  for  the  present  Census,  but  the  figures  referable  to  that  of 
1891  are  sufficiently  illustrative.  The  figures  of  the  following  table  are  from 
Mr.  Eowntree's  work,  and  reference  may  also  be  made  to  Volume  VI.  of  the 
Census  Report  for  England,  Table  30,  Appendix  A,  and  to  the  Tenth  Decennial 
Report  for  Scotland,  Volume  I.,  page  331. 


Towns. 
1891. 

Newcastle-on-Tyne, 
London,  ... 
Leeds, 


Proportion  per  cent, 
of  Persons  living  more 
than  2  per  Room  to 
Total  Population. 

35 

19 

16 


Towns. 
1891. 
Sheffield, 
Liverjjool, 
Manchester, 


Proportion  per  cent, 
of  Per.sons  living  more 
than  2  per  Room  to 
Total  Population. 

11 

10 


Glasgow, 


59 


The  social  significance  of  this  contrast  has  its  value,  but  the  disparity 
presented  by  the  proportion  of  persons  so  living  in  the  several  cities  suggests  a 
fundamental  difference  in  the  average  size  of  room  which  we  may  endeavour  to 
elucidate. 

Dr.  Sykes,  in  the  Milroy  Lectures  for  1901,  states  that  in  England  the  cubic 
space  per  room  may  be  stated  as  varying  from  600  to  1,400  cubic  feet,  but 
mainly  from  800  to  1,200,  and  takes  the  average  of  1,000  cubic  feet  as  fairly 
representing  the  air-space  per  room  in  houses  of  less  than  five  apartments  in 
large  towns. 

Before,  however,  this  can  be  compared  with  corresponding  measurements  in 
Glasgow  some  further  consideration  is  necessary.  It  is  customary  in  Glasgow  to 
exclude  the  bed  space  and  lobby,  if  that  is  separated  by  a  door,  in  calculating  the 
cubic  capacity  of  a  room.  In  London,  on  the  other  hand,  where,  as  Dr.  Sykes 
informs  me,*  the  ordinary  house  has  a  front  and  a  back  room  on  each  floor,  there  is 
no  lobby  and  no  bed  recess,  while  any  recess  within  a  room  would  be  reckoned  as 
part  of  the  cubic  space  therein. 

Keeping  these  differences  in  view,  a  comparison  of  the  internal  air-space  in 
houses  in  both  cities  may  be  approached. 


Cubic  Space  per  House  in  Glasgow. 

By  the  Glasgow  Police  Act,  1866,  the  minimum  air-space  per  apartment  in 
new  houses  was  fixed  at  900  cubic  feet,  and  was  raised  to  1,000  cubic  feet  by  the 
Building  Regulations  Act,  1892.  The  following  measurements  taken  in  1886 
represent  the  average  in  three  districts.f 

*  Dr.  Sykes  since  writes  me  : — "  'J'he  Housiug  of  the  Working  Classes  Committee  of  the  London 
County  Council  made  building  regulations  approved  by  the  Council  on  3rd  December,  1889,  and  these 
regulate  the  size  of  rooms  in  new  buildings  for  the  working  classes  in  London.  With  a  minimum  of 
8J  feet  (ceiling),  the  minimum  floor  area  for  bedrooms  is  96  square  feet,  and  for  living  rooms 
144  square  feet.  This  means  respectively  816  and  1,244  cubic  feet,  and  the  mean  of  the  two  is  1,020. 
The  average  always  seems  to  come  near  1,000." 

+  See  "  Vital  Statistics,"  Part  II.,  pp.  70,  71.    (Dr.  Russell.) 


23 


(1)  Cubic  Contents  of  Houses  in  Tradeston. 


SrzE  OF  House. 

No.  of 
Houses. 

Mean  Cubic 

Space 
per  House. 

Mean  Cubic 

Space 
per  Room. 

1  Apartment, 

100 

1,007 

1,007 

2  Apartments, 

104 

2,077 

1,038 

3  Apartments, 

110 

3,656 

1,219 

There  are  314  liouses  in  this  group,  all  in  Tradeston,  which  was  feued  by 
the  Trades'  House  at  the  end  of  last  century. 


(2)  Cubic  Contents  of  Houses  in  District  15,  or  Woodside. 


Size  of  House, 

No.  of 
Houses. 

Mean  Cubic 

Space 
per  House. 

Mean  Cubic 

Space 
per  Room. 

1  Apartment, 

100 

1,268 

1,268 

2  Apartments, 

100 

2,498 

1,249 

3  Apartments, 

23 

3,722 

1,240 

These  223  houses  are  nearly  all  in  tenements  then  recently  built  in  Hopehill 
Eoad,  and  fairly  represent  the  ordinary  run  of  artizans'  dwellings  erected  by 
private  enterprise  under  the  usual  conditions  of  the  Glasgow  Police  Act,  1866. 


(3)  Cubic  Contents  of  Houses — Oatlands  and  Overnewton. 


Size  of  House. 

No.  of 

Houses. 

Mean  Cubic 

Space 
per  House. 

Mean  Cubic 

Space 
per  Room. 

1  Apartment, 

116 

1,344 

1,344 

2  Apartments, 

137 

2,637 

1,318 

3  Apartments, 

101 

3,999 

1,333 

These  354  houses  are  all  situated  on  the  lands  of  Oatlands  and  Over- 
newton, which  were  purchased  by  the  Improvement  Trust,  and  feued  m  ac- 
cordance with  a  plan  carefully  laid  out  by  the  Master  of  Works,  reserving  in 
each  case  a  central  square  as  breathing  space.  They  represent  the  best  class  of 
modern  artizans'  dwellings  in  the  City. 


24 


This  is  the  record  of  measurements  taken  in  1886,  and  may  be  compared  with 
the  following  figures,  which  show  the  average  cubic  space  in  houses  whose  erection 
was  sanctioned  during  the  past  decade,  and  for  which  I  am  indebted  to  the  Master 
of  Works. 


Size  of  House. 

No.  erected 
Sept.  1891,  Aug.  1901. 

Cubic  Contents, 
Including  Lobby 
and  Bed  Space. 

Cubic  Contents, 
Excluding  Lobby 
and  Bed  Space. 

1  apartment, ... 

5,665 

1,700 

1,300* 

2  apartments, 

17,355 

(a)  Room, 

1,400 

(b)  Kitchen, 

1,200 

Together,  ... 

3,400 

2,600 

This  gives  the  average  free  air-space  per  room  in  houses  of  recent  construc- 
tion at  1,300  cubic  feet,  and,  if  we  add  the  240  cubic  feet  of  bed-space,  to  meet  the 
inclusion  of  recesses  within  a  room  which  are  reckoned  in  London  as  forming  part 
of  the  entire  cubic  space  thereof,  we  have  in  our  most  recently  erected  one  and 
two-apartment  houses  air-space  which  exceeds  by  one-half  the  average  contents  of 
the  room  in  London,  and  indieates  three  persons  per  room  as  the  equivalent  of 
the  English  standard  of  two.  In  ten*  of  our  districts  only  is  the  average  occupancy 
of  one-apartment  houses  lower  than  this. 

Intercensal  Changes  of  Population  and  in  House  Accommodation  in  the 
Various  Sanitary  Districts  during  1891-1901. 

In  order  to  epitomise  this,  the  following  Table  has  been  prepared  :— It  shows 
that  in  twelve  Districts  of  Old  Glasgow  the  population  has  decreased  during  the 
decade  at  rates  varying  from  1'5  per  cent,  in  Blythswood  to  33  per  cent,  in  Bridge- 
gate  and  Wynds.  Between  these  extremes  lie  High  Street  and  Closes  East  and 
West,  Monteith  Row,  St.  Andrew  Square,  Calton,  and  St.  Enoch  Square  in  the 
Central  and  East  Central  Districts  ;  Anderston  in  the  West ;  Kingston,  Laurieston, 
and  Gorbals  in  the  South.  In  all,  save  High  Street  and  Closes  West,  the  houses 
have  likewise  been  reduced  in  number. 

In  the  other  Districts  of  Old  Glasgow  the  increase  in  population  has 
ranged  from  1  per  cent,  in  St.  RoUox  to  25  Q  per  cent,  in  Springburn  and  Rock- 
villa,  and  in  these  also  the  houses  have  increased  in  number,  save  in  Brownfield, 
where  the  population  has  increased  by  3  per  cent.,  while  the  houses  have  been 
reduced  by  1'9  per  cent. 

In  all  the  added  Districts  the  rates  of  increase  have  reached  a  high  level, 
save  in  Hillhead  where  the  population  has  increased  by  10'3  per  cent,  and  the 
houses  by  9 '9  per  cent. 

In  Maryhill  the  population  has  been  doubled  during  the  decade,  and  its 
houses  have  been  added  to  by  118-6  per  cent. 


*  See  Table  VII.,  Appendix. 


25 


Movements  of  the  Population  in  relation  to  Housing  during  the 
Decennium  1891-1901. 


Sanitary  Districts. 

Population,  exchisive  of 
Institutions  and 
Sliipping. 

Inhabited  Houses. 

Empty  Houses. 

Percentage 
Increase. 

Percentage 
Decrease. 

Percentage 
Increa.se. 

Percentage 
Decrccise. 

1S91. 

1901. 

—   Ely  thswood, ...  ... 

1-5 

3-2 

4-7 

2-8 

1.  Exchange,  ... 

1  1  -0 

X  X  -1 

11-4 

■J  U 

2.  Port-Dundas, 

144 

16-7 

4-6 

1  7-0 

.3.  Hi^h  Street  and  Closes  West, 

4-3 

1-2 

4-6 

o  u 

4.  St.  RoUox,  ...   

ro 

1-7 

2-6 

3-1 

k)  X 

5.  Bellgrove  and  Dennistoun,  ... 

25-3 

25-5 

3-8 

t:  O 

6.  High  Street  and  Closes  East, 

10-G 

S-3 

7-9 

rt  _j 

7.  Greenhead  and  London  Road, 

2t-7 

23-7 

3-1 

8.  Barrowfield, ... 

2-8 

0-6 

O  -J 

9.  Monteith  Row,   

8-1 

10-0 

O  X 

10.  St.  An(h-ew  Square, 

2-8 

7-7 

5-0 

*x  i 

11.  Calton,   

5-1 

7  '0 

12.  St.  Enoch  Square,  

30-7 

31-0 

X  X  -J 

o  o 

13.  Brownfield,  ... 

3  3 

1-9 

31 

o  o 

14.  Bridgegate  and  Wynds, 

33-8 

30-4 

12-5 

2-4 

15.  "VVoodside, 

19-8 

19-6 

4-4 

3-7 

16.  Cowcaddens, 

8-1 

5-2 

7-1 

17.  Kelvinhaugh  and  Sandyiord, 

3-8 

3-9 

3-S 

3-6 

18.  Anderston,  ... 

2-8 

3-8 

2-7 

2-6 

19.  King.ston, 

1-9 

3-3 

4-4 

2-7 

20.  Laurieston,  ... 

2-1 

5-1 

3-9 

3-6 

21.  Hutcheson  Square,  ... 

10-4 

9-4 

3-3 

3-2 

22.  Gorbals,   

7-1 

10-2 

3-7 

3-7 

—   Springburn  and  Rockvilla, ... 

25-6 

29-5 

3-7 

3-S 

23.  Govanhil],  

36-3 

43-2 

3-6 

3-4 

24.  Crossbill,   

76-5 

87-7 

6'0 

5-7 

25.  Langside  and  Mount  Florida, 

58-5 

73-6 

10-7 

7-8 

26.  Pollokshields,  E.,  and  Strathbungo, 

30-0 

41-3 

7-0 

6-2 

27.  Pollokshields,  W.,  and  Bellahouston, 

61-4 

69-2 

5-4 

5 '7 

28.  Hillhead,   

10-3 

9-9 

9  0 

5-1 

29.  Kelvinside,  ... 

28  0 

34-2 

8-3 

8-0 

30.  Maryhill,   

100-4 

118-6 

6-S 

8-4 

31.  Possilpark  and  Barnhill, 

35-9 

36-7 

•  5-5 

5-2 

—  Institutions, 

5M 

—  Shipping, 

65-5 

City,*  

15-75 

15-21 

4-7 

4-5 

Including  Institutions  and  Shipping. 


26 


In  a  general  way,  iiouses  and  population  have  increased  or  decreased 
together,  and  the  movement  in  both  presents  a  fair  degree  of  relationship.  But  in 
High  Street  and  Closes  West  and  in  Brownfield  the  population  and  houses  have 
moved  in  opposite  directions. 

The  percentage  increase  and  decrease  in  population  and  in  houses  in  these 
districts  will  be  found  in  the  foregoing  Table.  The  actual  change  in  the 
houses  is  as  follows :  — 

High  Street  and  Closes  West — 


1891,  ... 

1  Apt. 
708 

•2  Apts. 
..  772 

3  Apts. 
..  257 

4  Apts. 
...  94 

5  Apts.  and  upwards. 
36 

All  Sizes. 
1,867 

1901,  ... 

595 

..  894 

..  299 

...  73 

28 

1,889 

Difference,  - 

-113 

+  122 

+  42 

-  21 

-8 

+  22 

Brownfield 

1891,  ... 

128  . 

422 

..  88 

..    50  . 

8 

696 

1901,  ... 

135  . 

..    426  . 

..  71 

..    40  . 

11 

683 

Difference, 

+  7 

+  4 

-17 

-10 

+  3 

-13 

In  High  Street  and  Closes  West  there  has  been  much  demolition  and 
rebuilding.    It  contains  one  of  the  areas  of  the  Improvement  Trust  Act,  1897. 

Brownfield  is  completely  built  over,  and  lO'S  per  cent,  of  the  total  houses  are 
farmed  out. 

In  a  former  section  we  have  seen  that  the  one-roomed  houses  within  the 
area  of  Old  Glasgow  were  reduced  by  596  and  their  population  by  3,712. 
Can  this  displaced  population  be  traced  ?  It  has,  as  we  have  also  seen, 
failed  to  affect  the  average  occupancy  of  the  remaining  one-roomed  houses  in 
Old  Glasgow,  which  has  been  reduced  from  3"232  to  3'173.  But  in  carrying  the 
enquiry  into  the  several  districts,  we  find  seven  in  which  the  average  occupancy 
has  increased.    These  are  stated  in  the  following  Table : — 


One-Apartment  Houses. — Aveeage  Number  of  Inmates  per  House  in 
Districts  where  the  Proportion  in  1901  exceeds  that  of  1891.  (See 
also  Table  VII.,  Appendix.) 


Average  Number  of  Persons 
per  Room. 

Difference  per 
1,000  Houses. 

IS9I. 

1901. 

St.  Andrew  Square,  ,.. 

3-352 

3-601 

249 

High  Street  and  Closes  East,  ... 

3-240 

3-440 

200 

Cow;caddens,     ...        ...        ...  ... 

3-164 

3-255 

91 

Laurieston, 

3-050 

3-162 

112 

Monteith  Row, ... 

3-011 

3-151 

140 

Brownfield,       ...  ... 

2-781 

3-030 

249 

St.  Enoch  Square, 

2-962 

2-973 

11 

Old  Glasgow, 

3-232 

3-173 

-59 

27 


It  will  be  observed  that  the  order  of  room  density  is  maincained  in  both 
periods,  save  in  Brownfield;  and  if  we  here  again  discard  the  decimal,  and 
regard  the  change  as  expressing  the  actual  increase  in  the  nvimber  of  inmates 
per  1,000  houses  of  this  size,  we  find  Brownfield  and  St.  Andrew  Square  to  have 
their  occupants  increased  by  249,  High  Street  and  Closes  East  by  200,  Mon- 
teith  Row  by  140,*  and  Laurieston  by  112.  This  is  one  result  in  detail  of  the 
displacement,  while  the  balance  will  be  fairly  expressed  in  the  increased 
occupancy  of  two-apartment  houses.  Within  the  old  area  this  has  changed 
only  from  4'950  to  4'952  persons  per  house,  a  difference  which  may  be  neglected. 
But,  again,  when  we  carry  the  comparison  into  the  several  districts  and  tabulate 
those  only  in  which  it  has  increased,  a  striking  cleavage  occurs  between  those  districts 
Avhich  have  also  had  an  increase  in  their  one-roomed  occupancy  and  those  in  which 
this  has  not  occurred.  The  column  of  differences  in  the  following  Table  has 
been  arranged  to  show  this:  — 


Two- Apartment  Houses. — Average  Number  of  Inmates  per  House  in 
Districts  where  it  has  increased  in  1901. 


Districts. 

Average  Number  of 
Persons  per  House. 

Difference  per  1,000 
Houses. 

1S91. 

1901. 

A. 

B. 

High  Street  and  Closes  West  (3),     . . . 

4-763 

4-775 

12 

Do.  do. 

East  (6),  ... 

4-837 

4-899 

62 

Greenhead  and  London 

Road  (7), 

5-237 

5-267 

30 

Barrowfield 

(8),  ... 

5-073 

5-156 

83 

Monteith  Row 

(9),  ... 

4-814 

5-166 

352 

St.  Andrew  Square 

.      (lOj,  ... 

4-582 

4-806 

224 

Calton  ... 

.      (11),  ... 

4-927 

4-949 

22 

St.  Enoch  Square 

•      (12),  ... 

4-616 

4-758 

142 

Brownfield 

.      (13),  ... 

4-912 

5-115 

203 

Kelvinhaugh  and  Sandyford  (17), 

4-498 

4-560 

62 

A  nderston 

.      (IS),  ... 

5-052 

5-063 

11 

Laui'ieston 

•      (20),  ... 

4-960 

5-121 

161 

Hutcheson  Square 

•       (22),  ... 

4-926 

4-988 

62 

Old  Glasgow, 

4-950 

4-952 

The  first  point  to  be  noted  in  this  Table  is  that  it  contains  all  save  one  of 
the  districts  in  which  we  have  already  seen  the  one-roomed  occupancy  to  have 
increased.    The  exception  is  Cowcaddens,  in  which  the  two-roomed  occupancy 

*  Tlie  portion  of  this  district  chiefly  affected  is  that  -which  lies  bet-sveen  Gallowgate,  Kent  Street, 

London  Street,  and  Charlotte  Street. 


28 


has  been  fractionally  reduced,  viz.,  from  5128  to  5-121  per  house.  But  it  also 
shows  that  the  increase  which  has  taken  place  in  the  two-roomed  occupancy  is,  with 
one  exception,  relatively  greater  in  those  districts  where  there  is  also  an  increase  in 
the  one-roomed  occupancy.  A  comparison  of  the  columns  of  difference  shows  the 
extent  of  this,  columns  A  and  B  distinguishing  between  the  districts  which  have 
and  those  which  have  not  a  coincident  increase  in  the  rate  of  occupancy  of  one- 
apartment  houses. 

In  a  manner  these  Tables  focus  results  only,  but  they  present  in  a  fairly 
concrete  form  the  districts  in  which  increasing  pressure  on  one  and  two  apart- 
ment houses  has  occurred.  To  proceed  beyond  this  requires  some  local  know- 
ledge of  the  boundaries  of  the  Sanitary  Districts.  But,  in  a  general  way,  High 
Street  and  Closes  East  and  West,  Bridgegate  and  Wynds,  Calton,  Monteith 
Row,  St.  Andrew  Square,  and  St.  Enoch  Sqiiare  fairly  lie  within  the  the  centre 
of  the  area  of  Old  Glasgow,  and  in  these  the  one-apartment  houses  have  been 
reduced  in  number  during  the  ten  years  by  975.  Against  this,  there  has  been 
an  increase  in  Exchange  District  of  70,  and  in  Port-Dundas,  which,  however, 
is  further  removed,  of  78.  Bellgrove  and  Dennistoun  District  has  163  added 
hou.ses  of  one  ajDartment ;  Greenhead  and  London  E,oad,  291 ;  but,  save  m  the 
extreme  western  limit  of  the  former,  it  is  doubtful  whether  any  of  the  displaced 
inhabitants  of  the  Central  Districts  seek  accommodation  so  far  removed  from 
their  original  houses. 

In  the  Western  District,  Anderston  has  204  fewer  houses  of  this  size,  and  it 
is  difficult  to  dissociate  from  this  the  increased  pressure  in  Brownfield  with  its 
rapid  development  of  the  farmed-out  house,  although  Kelvinhaugh  and  Sandy- 
ford  has  added  to  its  number  by  33. 

Similarly,  on  the  South-Side,  Kingston,  Laurieston,  and  Gorbals  have  fewer 
one-apartment  houses  by  449,  against  which  there  is  alone  an  increase  of  191  in 
Hutcheson  Square.  In  the  Northern  District  of  the  old  City,  Springburn 
and  Rockvilla  and  Woodside  have  added  461,  but  the  relatively  low  rate  of 
increase  in  the  occupancy  of  one-roomed  houses  in  Cowcaddens  suggests 
that  more  is  wanted  than  the  mere  provision  of  house-room  to  attract 
the  inhabitant  of  one  district  to  another  which  is  probably  more  remote 
in  its  associations  than  in  actual  distance  from  that  to  which  he  has  been 
accustomed.  Eent  and  employment  are  powerful  factors  in  determining 
residence,  but  local  associations  must  be  reckoned  with;  and  the  Tables  point 
to  the  formation  of  limited  areas  of  increased  pressure  on  house  accommoda- 
tion round  every  centre  of  considerable  displacement.  Broadly  speaking,  three 
such  exist,  in  the  Central,  West,  and  Southern  Districts  of  the  City. 


29 


V' 


Number  of  One-Apaetment  Houses  in  the  Sanitary  Districts  of 
Old  Glasgow  in  1891  and  1901. 


Sanitary  Districts. 

1891. 

1901. 

Increase. 

Decrease. 

Til 

jDlytnswooa, ... 

413 

313 

100 

1 

Exchange, 

670 

740 

7(1 

— 

Z 

Port-Dundas, 

254 

332 

78 

— 

6 

High  Street  and  Closes  W., 

708 

595 

— 

113 

4 

bt.  Kollox,  ... 

823 

781 

— 

42 

0 

Bellgrove  and  Dennistoun, 

3,196 

3,359 

163 

— 

/» 

D 

High  Street  and  Closes  East, 

501 

425 

— 

76 

17 
1 

vjrre6Dnea.Q  ana.  j-iOnQon  xYOdtu, 

4,461 

4,752 

291 

— 

o 

8 

Barrowfield, ... 

2,672 

2,543 

— 

129 

9 

Monteitn  Kow, 

174 

172 

— 

2 

Ob.   -£l.OCllcW   kjUUctlt?,                    ...  ... 

216 

173 

43 

i  1 

Oalton, 

1,957 

1,593 

— 

364 

12 

St.  Enoch  Square,  ... 

133 

74 

— 

59 

Id 

Brownfield,  ... 

128 

135 

7 

1  A 

14 

Bridgegate  and  Wynds, 

555 

237 

— 

:'.  is 

10 

Woodside, 

2,156 

2,245 

89 

— 

16 

Cowcaddens, 

1,464 

1,473 

9 

— 

17 

Kelvinhaugh  and  Sandyford, 

359 

392 

33 

— 

18 

Anderston,  ... 

1,854 

],650 

204 

19 

Kingston, 

1,482 

1,249 

233 

20 

Laurieston,  ... 

481 

437 

44 

21 

Hutcheson  Square,  ... 

4,086 

4,277 

191 

22 

Gorbals, 

752 

580 

172 

Springburn  and  Rockvilla. 

1,537 

1,909 

372 

Empty  Houses. 


Within  the  area  of  Old  Glasgow  in  1891,  5,440  houses,  or  4  4  per  cent,  of  the 
total,  were  unoccupied  on  the  night  of  the  Census ;  in  the  added  Listricts,  1,223, 
or  6'6  per  cent.,  were  unoccupied,  together  forming  4"7  per  cent,  of  the  total 
number  of  houses  within  the  whole  area.  At  the  present  Census,  7,274  were 
unoccupied,  which  is  4  5  per  cent,  of  the  total. 

It  is  unfortunate  that  the  returns  cannot  be  made  to  convey  information 
regarding  the  size  of  these. 

Within  the  area  of  Old  Glasgow  at  the  present  Census  the  number  of  empty 
houses  was  5,427,  or  4'i  per  cent. ;  in  the  added  Districts  they  numbered  1,847,. 
or  6 "3  per  cent.,  proportions  which  do  not  vary  much  from  these  obtaining  in 
1891.  In  1881  the  proportion  of  empty  houses  was  10  per  cent. ;  in  1871,  2 
per  cent. 


30 


Formula  for  Calculating  the  Annual  Increase,  1901-1911. 

During  the  intercensal  period  1891-1901,  the  Annual  Estimates  of  the 
3)opulation,  based  on  the  rate  of  increase  in  the  previous  decade  and  on  the 
number  of  inhabited  houses  returned  by  the  City  Assessor  in  June  of  each  year, 
differed  very  little  from  each  other.  In  the  earlier  years  of  the  decade,  the 
estimate  based  on  inhabited  houses  was  somewhat  lower  than  the  other,  but 
the  difference  gradually  inclined  the  other  way,  until  in  1900  the  Medical  Officer's 
estimate  exceeded  that  of  the  Kegistrar-General  by  11,761.  For  1901*  it  would 
have  exceeded  the  Census  by  900,  but  as  this  assumed  the  shipping  population  of 
1891  as  constant,  the  actual  difference  would  have  been  about  1,500.  The  result, 
therefore,  has  once  more  established  the  superiority  of  a  method  based  upon  data 
which  can  be  obtained  with  a  fair  degree  of  accuracy  each  year  over  one  which 
is  based  on  conditions  which  may  be  very  widely  departed  from  when  it  comes  to  be 
applied.  The  close  approximation  of  recent  results  is  no  doubt  largely  attri- 
butable to  the  annexation  of  the  outer  ring  in  November,  1891,  which,  as  we  have 
seen,  preserved  to  the  City  its  natural  increase,  although  it  may  be  partially 
explained  by  a  steadier  growth  of  the  population  in  recent  years. 

The  method  of  calculating  the  population  on  the  basis  of  the  number  of 
"  ^Inhabited  Houses  "  was  fully  discussed  in  the  Census  Report  for  1891,  and  we 
need  only  consider  here  the  alterations  which  have  occurred  in  the  factors 
employed.  At  the  Census  of  1891  the  average  number  of  persons  per  house  was 
found  to  be  4-778,  and  this  at  the  Census  of  1901  had  fallen  to  4-769. 

In  June,  1901,  the  number  of  "  Inhabited  Houses  "  as  returned  by  the 
City  Assessor  was  159,988,  or  4,584  in  excess  of  those  found  occupied  at  the  Census. 
After  allowing  for  the  natural  increase  of  the  City  during  the  intervening 
quarter,  there  remains  a  difference  of  about  2  5  per  cent,  to  be  accounted  for  chiefly 
by  houses  tenanted  but  not  occupied  on  the  Census  day.  This  difference  has  been 
allowed  for  in  the  Annual  Estimates  of  the  past  decade  by  deducting  1-5  per  cent, 
from  the  Assessor's  Return,  and,  though  the  data  at  command  might  suggest  a 
larger  allowance,  no  change  will  for  the  present  be  made,  so  that  the  formula  for 
the  annual  estimate  of  the  population  during  the  current  decade  will  be : — 
[(Tenanted  Houses  — IJ  per  cent.)  x  4*769] Shipping -|- Institutions  =  Population. 

Average  Rent  of  House  per  Year  and  of  Room  per  Week. 
Mr.  Henry  has  kindly  supplied  me  with  information  from  which  the  follow- 
ing approximate  average  rentals  have  been  calculated  for  1901 ;  the  figures  referable 
to  former  years  being  recast  from  earlier  Census  Reports  : — 

Number  of  Average  Rent  of 

Year.        Total  Rental.         "fj^on  Windowed  House  Room 

Rooms.  per  Year.  per  Week. 

1881,     ...         —         ...       _      ...       _      ...  £11     6    9  ...  — 

1891,    ...  £1,793,255  ...  142,985  ...  348,858  ...     12  10    9-98     ...    Is.  llfd.t 

1901,+  ...     2,162,920  ...  158,779  ...       —      ...     13  12    3         ...    2s.  Oid. 

*  See  note  thereon  in  Annual  Report  of  Medical  Officer  of  Health  for  1899-1900. 
t  The  average  weekly  rent  per  room  in  old  Glasgow  in  1891  was  Is.  9Jd. 

t  These  figures  apply  to  houses  alone,  but  there  were,  in  addition,  3,040  combined  houses  and 
shops  yielding  a  rental  of  £50,826,  which  are  excluded  from  the  calculation  of  average  rentals.  The 
increase  in  the  average  rent  per  house  is,  in  part  at  least,  related  to  the  increase  which  we  have  seen 
to  have  occurred  in  the  size  of  the  average  house  ;  but  the  increase  in  the  average  room  rental  quite 
definately  indicates  that  for  corresponding  accommodation  the  rent  paid  has  risen  during  the 
decennium. 


31 


Glasgow's  Outer  Ring. 

The  outer  ring  of  population  surrounding  Glasgow  proper,  which  the  Registrar- 
General  in  1881  first  constituted  into  a  Principal  Town  District  as  "  Glasgow 
Landward  and  Suburban"  is  described  in  his  27th  Detailed  Annual  Report  as 
consisting  of  the  landward  parts  of  the  City  (Registration)  Districts,  together  with 
the  Registration  Districts  of  Cathcart,  Eastwood,  Mary  hill,  Govan,  and  Partick. 

The  inclusion  of  a  considerable  portion  of  the  population  of  this  area  within 
the  City  boundary  by  the  extension  of  1891  has  terminated  the  existence  of  the 
outer  ring  as  thus  constituted,  but  the  rate  at  which  the  population  around  Glasgow 
is  increasing  may  be  deduced  from  a  comparison  of  the  rate  of  growth  of  the 
combined  population  of  the  civil  parishes  within  which  the  registration  districts 
just  mentioned  were  contained,  and  adding  thereto  that  of  Rutherglen.  These 
approximately  represent  the  total  population  within  a  radius  of  four  miles  of  the 
Exchange. 

The  population  in  1891  and  1901  was  as  follows; — 


Parishes. 

1891. 

1901. 

Glasgow, 

486,636 

571,569 

Govan, 

286,281 

34L443 

Eastwood, 

16,042 

18,886 

Cathcart, 

16,589 

28,358 

Rutherglen, 

16,178 

21,012 

Total, 

82L726 

981,268 

We  have  thus  a  numerical  increase  during  the  decennium  of  159,542,  repre- 
senting a  rate  of  19-4  per  cent,  for  the  whole  population  within  the  four-mile  radius, 
or  3-6  in  excess  of  the  rate  per  cent,  of  increase  within  the  Municipal  boundary. 

Proposed  Change  from  Present  Sanitary  Districts  to  Municipal  Wards. 

The  present  Sanitary  Districts  were  formed  in  1871,  when  Sir  William  T. 
Gairdner  was  Medical  Officer  of  Health  for  Glasgow.  The  history  of  the 
various  attempts  to  sub-divide  the  City  so  as  to  "  exhibit  the  local  variations  in 
our  vital  statistics  "  is  contained  in  Part  I.  of  the  "  Vital  Statistics  of  Glasgow," 
by  Dr.  Russell,  late  Medical  Officer  of  Health  of  the  City,  i'rom  the  account 
there  given,  it  appears  that  the  present  sub-divisions  were  a  compromise 
between  the  ten  Registration  Districts  of  the  City  then  existing,  and  which, 
"  embracing  a  population  of  30,000  to  40,000,  were  too  large,"  and  an  earlier 
proposal  "that  the  960  Enumeration  Districts  of  the  City,  formed  for  the 
purposes  of  the  Census  of  1861,  might  be  taken  as  the  basis."  The  complexity 
of  this  latter  scheme  proved  a  barrier  to  its  realisation,  and  although  some  use  was 
for  a  time  made  of  another  proposal,  which  had  been  submitted  to  the  Board  of 
Police  in  1865,  for  dividing  the  City  into  54  districts,  these  also  were,  for  the  most 
part,  soon  abandoned.    Recourse  was  then  had  to  the  Registration  Districts,  and 


32 


finally,  in  1871,  these  were  sub-divided  into  the  present  Sanitary  Districts.  The 
following  Table  shows  the  scheme  of  division,  the  numbers  only  of  the  Sanitary 
Districts  being  given  :  — 

Old  Registration  Districts.  Sanitary  Districts. 

Central,       ...  ...  ...  ...  1,  2,  3,  4. 

High  Church,  ...  ...  ...  5,6. 

Bridgeton,    ...  ...  ...  ...  7,  8. 

Calton,        ...  ...  ...  ...  9,  10,  11. 

Clyde,    ...  12,  13,  14. 

Blythswood,  ...  ...  ...  ...  Bl. 

Milton,        ...  ...  ...  ...  15,  16. 

Anderston,   ...  ...  ...  ...  17,  18. 

Tradeston,    ...  ..  ...  ...  19,  20. 

Hutchesontown,  ...  ...  ...  21,  22. 

Maryhill  (part),  ...  ...  ...  Rv. 

Springburn  (part),  ...  ...  ...  Sp. 

This  scheme  had  in  it  the  merits  and  defects  of  a  compromise.  By  making 
the  Sanitary  Districts  sub-divisions  of  the  Registration  Districts  the  statistical 
work  of  the  Department  was  simplified,  and  the  possibility  of  a  fontinued  error 
in  the  estimate  of  their  populations  could  be  avoided  by  comparison  with  the 
recurring  Census  Returns  of  each  Registration  District.  The  chief  defect  lay 
in  the  arbitrary  character  of  the  boundaries  of  the  sub-divisions  imposed  by 
the  limits  of  the  Registration  Districts.  These  latter  had  not  been  arranged 
for  sanitary  purposes,  and  though  an  eifort  was  made  within  the  limits  thus 
prescribed  to  make  each  of  the  sub-divisions  as  homogeneous  in  its  social  con- 
dition and  sanitary  circumstances  as  possible,  it  was  in  the  nature  of  things 
only  partially  successful.  In  1875  the  Registration  Districts  were  completely 
rearranged,  and  any  advantage  gained  by  subordinating  the  Sanitary  Districts 
to  them  was  lost,  but  very  wisely  no  attempt  was  then  made  to  remodel  these  latter, 
for  they  had  already  proved  most  serviceable,  and  were  destined  in  the  next 
quarter  of  a  century  to  exercise  a  powerful  influence  on  the  sanitary  history 
of  Glasgow. 

Great  changes  have  passed  over  the  City  since  these  Sanitary  Districts 
were  formed.  The  various  improvement  schemes  and  railway  extensions  have 
transformed  many  of  the  old  plague-spots  of  the  City,  and  swept  away  not 
a  few  of  its  historic  slums,  so  that  districts  like  the  notorious  No.  14,  which 
in  these  early  days  of  sanitation  were  a  synonym  for  all  that  was  insanitary  and 
unhealthy,  are  now  rapidly  approaching  the  average  death-rate  of  the  City. 
This  transformation  is  reflected  in  the  movements  of  the  population  as  shown 
in  the  following  Table,  which,  for  obvious  reasons,  relates  only  to  Old. 
Glasgow :  — 


33 


Population. 


Sanitaby  Districts. 

1871. 

1881. 

1891. 

1901. 

Percentage,  Increase  and 
Decrease,  1871-1901. 

L^,   X>llU^cga»UtJ  ciLLijL   vv  y  iiyjiaj        ...  ... 

12.  St.  Enoch  Square,  ... 
6.  High  Street  and  Closes  East, 

14,294 
7'807 
17,532 

7,798 
3*660 
7,745 

5,689 
3,458 
7,487 

3,880 
3,000 
7,102 

|>  Over  50  decrease. 

10.  St.  Andrew  Square, 

8,026 

4,151 

4,418 

4,794 

Over  40  "/^ 

il\J,     J-JdjUilCoLUxlj      ■••                ...  ■■• 

3.  High  Street  and  Closes  West, 
22.  Gorbals,   

12,305 
12^621 
16,811 

9,131 
10,058 
13,156 

9,108 
9^356 
13,544 

8,986 
9,669 
13,096 

j.  Over  20  7^ 

  X>iy  ullo  WUUQj                 ...           ...  ... 

11.  Calton, 

33.442 
25,637 

26  789 
22'094 

28,543 
22^637 

28,548 
22'l69 

1  Over  10  7„ 

18.  Anderston,  ... 

V3»    JL-Jdrl  1  LI  W  ll<:71Uj  ...              ...              ...              -  -  . 

1.  Exchange, 

Q    TVrnnf  pitVi  T^nw 

JJJ.\Jl±VCHjLl  XliU  W ,              ...                ...  ... 

16.  Cowcaddens, 

31,630 
30  108 
26,354 
4,513 
19'270 

29,031 
28  807 
20^617 
4  914 
15^233 

29,670 
26,944 
21^663 
4,643 
16^235 

28,858 
27,696 
24,431 
4,267 
18^206 

) 

I  Under  10  7„  „ 

2.  Port-Dundas, 

L  fJi     J_>A  \J  vv  lliidvj.j     ...                ...                ...  ... 

19.  Kingston, 

5,305 
3  702 
36^897 

4,704 
3  826 
37^935 

4,678 
3  797 
4M13 

5,346 
3,924 
40^407 

j.  Under  10  "  j  increase. 

4.  St.  RoUox,  

12,988 

14,252 

15,751 

15,907 

Over  20 

17.  Kelvinhaugh  and  Sandyford, 

21,083 

26,628 

30,523 

32,234 

Over  50 

21.  Hutcheson  Square,  ... 

38,811 

54,704 

63,493 

70,229 

Over  80  7. 

5.  Bellgrove  and  Dennistoun, ... 

40,938 

54,195 

63,348 

79,211 

Over  90  7^ 

7.  Greenhead  and  London  Road, 

30,520 

44,795 

52,747 

66,197 

Over  100  "/^ 

15.  Woodside,  ... 

—  Springburn  and  Rockvilla, ... 

27,116 
12,732 

45,080 
22,217 

58,609 
28,278 

70,145 
35,527 

1  Over  150  7^ 

In  this  summary  the  districts  are  arranged  in  order,  beginning  with  those 
showing  the  largest  decrease,  and  the  result  is  to  bring  out  in  bold  relief 
the  revolution  which  they  have  undergone.  This  is  further  illustrated  by  the  = 
following  comparison : — 

Number  of  Districts. 


District  Populations.  1871.  1901. 

Over  70,000,  ...  ...  —  ...  ...  3 

60,000  to  70,000,...  ...  —  ...  ...  1 

50,000  to  60,000, ...  ...  —  ...  ...  — 

40,000  to  50,000,...  ...  1  ...  ...  1 

30,000  to  40,000,...  ...  6  ...  ...  2 

20,000  to  30.000,...  ....  4  ...  ...  5 

10,000  to  20,000,...  ...  8  ...  ...  3 

Under  10,000,  ...  ...  5  ...  ...  9 


In  both  1871  and  1901  seven  of  the  districts  had  populations  exceeding 
30,000 ;  but  whilst  in  1871  only  one  district  had  a  population  exceeding  40,000,  now 
four  have  populations  exceeding  that  number,  and  three  of  these  have  populations 
exceeding  70,000.  By  contrast,  while  formerly  only  five  districts  had  populations 
under  10,000,  now  there  are  nine  such.  It  is  manifest  that  some  of  the  present 
districts  have  overgrown  the  limits  of  suitability  for  sanitary  statistical  purposes, 
and  local  knowledge  indicates  that  whatever  claim  to  homogeneity  they  at  one  time 
possessed  has  been  almost  entirely  lost.  For  both  reasons  it  seems  desirable  to  alter 
the  present  arrangement  either  partially  or  wholly,  and  the  present  time  is  particularly 


34 


opportune  for  tlie  consideration  of  the  question.  Two  methods  of  dealing  with 
it  suggest  themselves.  We  may  retain  the  present  divisions,  grouping  those 
which  have  become  too  small  and  sub-dividing  those  which  have  outgrown 
their  usefulness,  or  we  may  substitute  a  scheme  of  sub-division  of  the  City  on 
entirely  different  lines.  If  the  former  plan  is  adopted,  Districts  3  and  6,  9  and 
10,  and  12  and  14  suggest  themselves  as  convenient  combinations,  while  the  larger 
districts,  some  of  which  have  grown  to  the  proportions  of  considerable  towns,  could  be 
some  of  which  have  grown  to  the  proportions  of  considerable  towns,  could  be 
sub-divided  so  as  to  produce  Sanitary  Districts  of  moxB  reasonable  size.  But 
there  is  much  to  recommend  a  complete  change  of  basis  for  these  sub-divisions ; 
and  the  quickening  of  local  interest  in  every  detail  of  communal  life  points  to 
the  Municipal  Ward  as  affording  the  limits  within  which  these  may  be  recast. 
Vital  statistics  gain  much  both  in  interest  and  value  when  viewed  in  the  light  of 
an  intimate  knowledge  of  the  local  circumstances  which  influence  them,  and  a 
Ward  death-rate  would  afford  a  standard  by  which  its  least  sanitary  areas 
might  be  compared.  It  is  probable  also  that  the  present  Hegistration  Districts 
of  the  City  will,  ere  long,  require  revision,  and  if  this  is  done,  there  can  be 
little  doubt  that  the  present  Municipal  Wards  will  form  the  basis  of  the  recon- 
struction scheme.  The  only  objection  which  can  be  urged  against  this  pro- 
posal is  that  continuity  in  our  vital  statistics  will  for  a  time  be  broken; 
but  in  view  of  the  changes  which  have  taken  place  in  the  present  Districts 
within  the  last  thirty  years,  this  objection  loses  much  of  its  force.  As  it 
is  expected  that  the  Census  Reports  will  in  future  furnish  information 
as  to  the  Wards  which  has  hitherto  only  been  given  for  the  City  as  a  whole 
(and  which  it  has  been  impossible  to  abstract  in  the  limited  time  during 
which  the  special  staff  of  this  Department  is  permitted  access  to  the  enumeration 
books),  investigations  of  considerable  importance- — ^as,  for  example,  into  occupational 
death-rates — which  are  now  impossible,  might  be  pursued  with  advantage.  This 
would  not,  however,  lessen  the  need  for  the  facilities  which  have  been  afforded  us 
at  each  Census  since  1871,  because  it  will  still  be  necessary  to  sub-divide  the  larger 
Wards,  and  the  data  for  the  sub-divisions  can  only  be  obtained  from  the  enumera- 
'tion  books  as  hitherto. 

The  first  question  to  be  considered  is  the  population  of  the  Wards,  and,  by 
adopting  a  grading  similar  to  that  already  used  for  the  Sanitary  Districts,  we  have 
the  following  series — the  figures  for  the  present  Sanitary  Districts  being  added 
for  comparison : — 


Population. 

Wards. 

Sanitary  Districts. 

Number. 

Average 
Population. 

Number. 

Average 
Population. 

Over  50,000,   

1 

53,476  ■ 

4 

71,445 

40,000  to  50,000,  ... 

4 

42,835 

1 

40,407 

30,000  to  40,000,  ... 

11 

34,768 

3 

34,473 

20,000  to  30,000,  ... 

4 

26,145 

7 

25,227 

10,000  to  20.000,  ... 

3 

14.089 

5 

14,977 

Under  10,000,   

2 

3,801 

13 

6,202 

Average  for  City. 

30,468 

35 

From  these  data  it  will  be  seen  that  the  Wards,  sub-divided  as  proposed,  will 
form  as  suitable  districts  as  any  that  can  be  produced  by  a  rearrangement  of  those 
presently  existing. 

If,  as  a  general  principle,  the  adoption  of  the  Municipal  Ward  as  the  basis  of 
future  statistics  commends  itself,  a  plan  of  sub-division  will  require  to  be 
formulated,  which,  while  maintaining  fairly  comparable  numerical  proportions, 
will  aim  at  a  certain  uniformity  of  social  conditions  and  surroundings.  District 
14  formerly  had  these  qualities;  Districts  13,  16,  and  Kelvinside  now  present 
them ;  but  Blythswood,  Monteith  Row,  and  Bellgrove  and  Dennistoun  have  each 
populations  living  under  conditions  as  diverse  as  those  presented  by  the  City  itself. 

In  view  of  a  rearrangement  on  the  lines  here  suggested,  the  whole  details  of 
housing  and  population  already  dealt  with  in  relation  to  the  present  Sanitary 
Districts  have  been  recast  for  the  several  Municipal  Wards,  and  form  Tables  VIII. 
to  XIV.  of  the  Appendix. 


\ 


APPENDIX. 


38 


TABLE  I.— Glasgow:  Acreage;  Comparative  Statement  of  Population;  Houses  (Inhabited  and  Empty) 

AND  per  Windowed  Room;  and  Percentage  of  Irish  Born  at  thi 


POPULATION. 

SANITARY  DISTRICTS. 

Acreage. 

Without  Institutions 
and  Shipping, 

Institutions. 

Shipping. 

Total. 

Difference  of  Total 
Populations. 

1901. 

1891. 

1901. 

1891. 

1901. 

1891. 

1901. 

1891. 

1901. 

Increase. 

Decrease. 

BLYTHSWOOD,  ...   

266 

28,438 

28,016 

105 

532 

28,543 

28,.548 

5 

1. 

EXCHANGE,  

215 

19,983 

22  212 

1,680 

2,219 

21,663 

24,431 

2,768 

2. 

PORT-DUNDAS,   

73 

4,655 

5,. 326 

23 

20 

4,678 

5,346 

668 

3. 

HIGH  STREET  AND  CLOSES  WEST,... 

42 

9,223 

8,827 

133 

842 

9,356 

9,669 

313 

4. 

ST.  ROLLOX,  

45 

15,751 

15,903 

4 

15,751 

15,907 

156 

5. 

BELLGROVE  AND  DENNISTOUN, 

1,327 

62,208 

77,923 

1,140 

1,288 

63,348 

79,211 

15,863 

6. 

HIGH  STREET  AND  CLOSES  EAST,  . 

50 

5,6.35 

5,037 

1,852 

2,065 

7,487 

7,102 

385 

7. 

GREENHEAD  AND  LONDON  ROAD, 

897 

51,787 

65,090 

960 

1,107 

52,747 

66,197 

13,450 

8. 

BARROWFIELD  

123 

26,944 

27,696 

26,944 

27,696 

752 

9. 

MONTEITH  ROW   

115 

4,643 

4,267 

4,643 

4,267 

376 

10. 

ST  ANDREW  SQUARE,  

KJ  A  •     Xi.Ait  JUr  AIL  Aj  ■  ¥                  w  A  A  Aft  AJ)        •  •  •                  •  •  •                  ■  ■  • 

22 

4,124 

4,010 

294 

784 

4,418 

4,794 

376 

11. 

CALTON   

66 

21,747 

20,640 

890 

1,5-29 

22,637 

22,169 

468 

12. 

ST.  ENOCH  SQUARE,   

84 

3,429 

2,376 

576 

29 

48 

3,458 

3,000 

458 

13. 

RROWNFIELD          .  . 

JJXIW  V¥  Xl  A  X  J_JAJA/)               •••  ••■ 

11 

3,451 

3,564 

337 

316 

9 

44 

3,797 

3,924 

127 

14. 

BRIDGEGATE  AND  WYNDS,  ... 

35 

5,689 

3,766 

114 

5,689 

3,880 

1,809 

15. 

WOODSIDE   

336 

58,257 

69,787 

352 

358 

58,609 

70,145 

11,536 

16. 

COWCADDENS, 

61 

16,2.36 

17,550 

656 

16,235 

18,206 

1,971 

17 

KELVINHAUGH  AND  SANDYFORD. 

°*  »  '  1  J  T  AX¥  XaXA  W  VI  A  A     ZA  J.¥  Ar             AA\  A'  A  A        Al.  A'  9      -  ■  ' 

626 

29,538 

30,673 

642 

880 

343 

681 

30,623 

32,234 

1,711 

18. 

ANDFR'^TON 

127 

29,251 

28,422 

361 

349 

58 

87 

29,670 

28,858 

812 

19. 

KINGSTON,   

389 

40,863 

40,079 

45 

205 

328 

41,113 

40,407 

706 

20. 

LAURIESTON,   

49 

8,850 

8,662 

179 

311 

79 

13 

9,108 

8,986 

122 

21. 

HUTCHESON  SQUARE,   

453 

63,493 

70,127 

102 

63,493 

70,229 

6,736 

22. 

GORBALS,   

48 

13,199 

12,264 

345 

832 

13,544 

13,096 

448 

— 

SPRINGBURN  AND  ROCKVILLA, 

866 

28,278 

35,527 

28,278 

35,527 

7,249 

23. 

GOVANHILL,...   

360 

17,014 

23,191 

17,014 

23,191 

6,177 

OA 

vXlUooxllLilj,  ... 

4,320 

7,626 

4,320 

7,626 

3,306 

25. 

LANGSIDE  AND  MOUNT  FLORIDA,  ... 

420 

9,141 

14,487 

196 

360 

9,337 

14.847 

5,510 

26. 

POLLOKSHIELDS  AND  STRATHBUNGO. 

243 

9,869 

12,830 

9,869 

12,830 

2,961 

27. 

POLLOKSHIELDS,  WEST,  AND  BELLA- 
HOUSTON,  

1,278 

3,538 

5,711 

3,538 

5,711 

2,173 

28. 

HILLHEAD,  

130 

7,738 

8,537 

7,738 

8,537 

799 

29. 

KELVINSIDE,   

765 

5,526 

7,074 

.664 

716 

6,190 

7.790 

1,600 

30. 

MARYHILL,  

1,183 

16,798 

33,661 

1,528 

1,980 

4 

16 

18,330 

35,657 

17,327 

31. 

POSSILPARK  AND  BARNHILL, 

1,642 

14,908 

20,263 

1,097 

1,431 

16,005 

21,694 

5,689 

Totals  within  Municipal  Boundary. 

12,681 

644,623 

741,124 

12,800 

19,347 

760 

1,241 

658.073 

761,712 

103,639 

1 


3a 


riNDOwED  Rooms  (Total  Number  and  Number  per  House);  Persons  peh  Acre;  per  Inhabited  House, 
Exsus  Periods,  189T  and  1901,  in  each  Sanitary  District. 


HOUSES. 

WINDOWED  ROOMS. 

PERSONS  PER  1 

Percentajie  of 

1891. 

1901. 

1891. 

1901. 

Number  per 
Inhabited  House 
(exchiding  In.sti- 
tutions  and 
Shipping). 

Acre  (includins 
Institutions  and 
Shipping). 

House  (exclud- 
in<r  Institutions 
and  Shipping), 

Room  (exclud- 
ing Institutions 
and  Shipping). 

Irisli  born. 
(Whole  Popula- 
tion.) 

E  ni  ]i  t  y . 

Inlitibited. 

Empty, 

Inhabited 
Houses. 

Institu- 
tions. 

Inhabited 
Houses. 

Institu- 
tions. 

1891 

1901. 

1891. 

1901. 

1891. 

1901. 

1891. 

1901. 

1891. 

1901. 

.3,537 

276 

5,360 

154 

22,568 

36 

21,956 

771 

4-076 

4  096 

107 

107 

5-136 

5-2-27 

1  -260 

1 

1  -276 

4-73 

5-39 

Bl. 

-J,  002 

285 

4,458 

181 

11,834 

386 

12,387 

435 

2-957 

2-779 

101 

114 

4-993 

4-983 

1-689 

1-793 

6-95 

6-74 

1. 

977 

47 

1,140 

234 

1,830 

2,072 

1-873 

1-818 

64 

73 

4-765 

4-672 

2-544 

2-570 

14-37 

12-31 

2. 

1,867 

91 

1,889 

110 

3,803 

44 

3,808 

216 

2-037 

2-016 

223 

230 

4-940 

4-673 

2-425 

2-318 

1114 

7-73 

3. 

3.279 

86 

3,334 

107 

6,541 

6,705 

1-995 

2-011 

350 

.353 

4-804 

4-770 

2-408 

2 -.372 

10-44 

9-71 

4. 

13,092 

517 

16,429 

777 

30,071 

296 

37,902 

346 

2-297 

2-307 

55 

60 

4-752 

4-743 

2-069 

2-056 

9-64 

8-41 

5. 

1,205 

104 

1,105 

48 

2,240 

637 

2,088 

721 

1-859 

1-890 

150 

142 

4-676 

4 -558 

2-516 

2-412 

15-21 

12-73 

6. 

11,288 

367 

13,959 

616 

20,160 

288 

25,466 

377 

1-786 

1-824 

62 

74 

4-587 

4  663 

2-569 

2-556 

9-26 

8-26 

7. 

(i,2.35 

555 

6,273 

307 

10,445 

10,786 

1  -675 

1-719 

219 

225 

4 -.321 

4-415 

2-580 

2  568 

12-29 

1005 

8. 

936 

30 

842 

36 

2,861 

2,502 

3-057 

2-971 

40 

37 

4-960 

5  068 

1-623 

1  -705 

9  76 

7-87 

9. 

814 

43 

751 

32 

1,973 

9 

1,819 

240 

2-424 

2  422 

201 

218 

5-066 

5-340 

2-090 

2-205 

16-00 

13-73 

10. 

4,989 

281 

4,616 

303 

8,895 

41 

8,523 

48 

1-783 

1-846 

343 

336 

4-359 

4-471 

2-445 

2  -422 

12-40 

10-36 

11. 

635 

80 

438 

16 

2,399 

1,565 

298 

3-778 

3-573 

41 

36 

5-400 

5-425 

1-429 

1-518 

12  -23 

15-23 

12. 

696 

22 

683 

38 

1,482 

14 

1.427 

16 

2-129 

2  089 

345 

357 

4-958 

5-218 

2-329 

2-498 

17-41 

19-37 

13. 

1,110 

158 

773 

19 

2,110 

1,700 

12' 

1-901 

2-199 

163 

111 

5-125 

4-872 

2-696 

2-215 

23-26 

14-28 

14. 

12,444 

567 

14,882 

572 

32,698 

11 

39,273 

11 

2 -6-28 

2-639 

174 

•209 

4-682 

4-689 

1-782 

1-777 

6-25 

5-69 

15. 

O,  DDI 

ouy 

\>,oo-± 

D,  WU 

1  735 

1-762 

266 

296 

4-447 

4  568 

2-563 

2  -592 

18-54 

14-80 

16. 

OOQ 
—  ijt7 

D,  --oO 

Mi 

OO  Alii 

3-765 

3-699 

49 

51 

4-921 

4919 

1-307 

1330 

5-88 

631 

17. 

D,  ioy 

I/O 

1  *i 
16 

17 

2-005 

2-035 

234 

— —  / 

4-742 

4-791 

2-365 

2-355 

16-91 

15-84 

18. 

^Ql 

41 

22,083 

2-646 

2-691 

106 

104 

4-817 

4-885 

1-820 

1-815 

6-97 

712 

19. 

1  856 

76 

66 

7 

O,0i'0 

2-098 

lab 

183 

•4-768 

4-919 

2-274 

2  344 

12-87 

1 3  "83 

20. 

13,866 

474 

15.168 

505 

27,097 

29,689 

19 

1  -954 

1  -957 

140 

155 

4-579 

4-623 

2-343 

2-362 

8-73 

8-34 

21. 

2,722 

106 

2,444 

93 

5,698 

18 

5,250 

36 

2  093 

2-148 

'282 

273 

4-849 

5-018 

2-316 

2  3.36 

16-36 

14-84 

22. 

5,699 

218 

7,379 

288 

11,003 

14,255 

1-931 

1  -932 

33 

41 

4-962 

4-815 

2-570 

2-492 

15-24 

13-05 

S.&R. 

3,483 

129 

4,987 

175 

9.677 

12.972 

2-778 

2  601 

54 

64 

4-8S5 

4-650 

1-758 

1-788 

4  16 

23. 

851 

64 

1.597 

97 

4,319 

6,952 

5-075 

4-353 

13 

23 

5-076 

4-775 

1-000 

1-097 

2-82 

24. 

1,786 

215 

3,100 

264 

8.547 

113 

13,527 

274 

4-786 

4-364 

22 

35 

5-118 

4-673 

1-069 

1071 

2-51 

25. 

1,951 

146 

2,756 

183 

9,626 

1.3,032 

4-934 

4-729 

41 

53 

5-058 

4-655 

1-025 

■984 

2-07 

26. 

559 

32 

946 

57 

5.396 

8,118 

9-653 

8-581 

4 

4 

6-329 

6-037 

1-656 

-703 

2  71 

27. 

1,585 

156 

1.742 

94 

10,137 

11,213 

6-396 

6-437 

60 

66 

4-882 

4-901 

-763 

-761 

2-18 

28. 

926 

84 

1,213 

108 

8,944 

525 

11,132 

441 

9-659 

8-956 

S 

10 

5-968 

5-691 

-618 

-635 

2-79 

29. 

3,268 

238 

7,145 

652 

9,046 

417 

18,811 

848 

2-768 

2-6.33 

15 

30 

5-139 

4-711 

1-857 

1-789 

12  68 

30. 

2,9lS 

169 

3.990 

217 

6,509 

176 

8.935 

85 

2-2.30 

2-239 

11 

13 

5-107 

5-078 

2-290 

2 -268 

10-82 

31. 

134,882 

6,663 

155,404 

7,274 

345.549 

3,. 309 

401.543 

5.695 

2  562 

2-584 

.55-48 

60-07 

4-778 

4-769 

1-865 

1  -846 

10-19* 

8 -68 

Applies  to  Old  Glasgow. 


40 


TABLE  II.— CENSUS,  1901— GLASGOAV:  AGE  AND  SEX  OF  THE  POPULATION  IN  SANITARY  DISTRICTS 


SANITARY  DISTRICTS. 


BLYTHSWOOD,   

EXCHANGE  

2.  :  PORT-DUNDAS,   

3.  I  HIGH  STREET  AND  CLOSES 
I  WEST, 

4.  ST.  ROLLOX,   

5.  BELLGROVE  &  DENNISTOUN, 

6.  HIGH  STREET  AND  CLOSES 

EAST, 

7.  GREENHEAD  AND  LONDON 

ROAD, 

8.  BARROWFIELD,   

9.  MONTEITH  ROW,  

10.  ST.  ANDREW  SQUARE,  ... 

1 1 .  CALTOW,   

12.  ST.  ENOCH  SQUARE, 

13.  BROWNFIELD,   

14.  BRIDGEGATE  AND  WYNDS, 

15.  WOODSIDE,  

16.  COWCADDENS,   

17-      KELVINHAUGH  AND  SANDY- 
FORD, 

18.  ANDERSTON,   

19.  KINGSTON,  

20.  LAURIESTON  

21.  HUTCHESON  SQUARE, 

22.  GORBALS  

—      SFRINGBURN  &  ROCKVILLA, 

23.  GOVANHILL,   

24.  CROSSBILL,  

25.  LANGSIDE  &  MT.  FLORIDA, 

26.  POLLOKSHIELDS  &  STRATH- 

BUNGO,  

27.  POLLOKSHIELDS,  WEST,  & 

BELLAHOUSTON, 

28.  HILLHEAD,  

29.  KELVINSIDE,   

30.  MARYHILL,  

31.  POSSILPARK  &  BARNHILL, 


/Without  Institutions, 
\Institutions, 
rWithout  Institutions, 
\lnstitutions, 
/Without  Shipping, 
\Shipping, 

/Without  Institutions, 
\Institutions, 
/Without  Shipping, 
\Shipping,...    _  ... 
/Without  Institutions, 
/Institutions, 
/Without  Institutions, 
/Institutions, 
/Without  Institutions, 
\lnstitutions,  ... 


/Without  Institutions,  ... 

/Institutions, 

r Without  Institutions,    . . . 

(^Institutions, 

(Without  Insts.  &  Shipping, 
Institutions, 
Shipping, 

{Without  Insts.  &  Shipping, 
Institutions, 
Shipping, ... 
/Without  Institutions,    . . . 
/Institutions, 
/ Without  Institutions,    . . . 
/Institutions, 
f  Without  Institutions,    . . . 
/Institutions, 

{Without  Insts.  <fe  Shipping, 
Institutions, 
Shipping,  _     _  ... 

(Without  Insts.  ife  Shipping, 
Institutions, 
Shipping,  

/  Without  Shipping, 
/Shipping,  

{Without  Insts.  &  Shipping, 
Institutions, 
Shipping,  

/Without  Institutions,  . . . 
/Institutions, 

/Without  Institutions,  ... 
/Institutions, 


/Without  Institutions, 
/Institutions, 


/Without  Institutions,  ... 

/Institutions, 

f  Without  Insts.  &  Shipping, 

-!  Institutions, 

[Shipping,  

/Without  Institutions,  ... 
/Institutions, 


Total  without  Institutions  and  Shipping, 
Total  Institutions,  ... 
Total  Shipping,      ...  ... 

Total  within  Municipal  Boundary, 


1                All  Ages. 

Under  1  Yeae. 

j  Males. 

Females. 

Total. 

Males. 

Females. 

Total. 

1 

13,414 

14,602 

2S,0]6 

191 

207 

398 

321 

211 

532 

2 

3 

5 

11,068 

11,144 

22,212 

303 

299 

602 

1,121 

1,098 

2,219 

22 

12 

34 

2,767 

2,559 

5,326 

115 

97 

212 

20 

20 

4,333 

4,494 

8,827 

123 

128 

251 

582 

260 

842 

... 

2 

2 

8,028 

7,875 

15,903 

225 

236 

461 

4 

4 

38,188 

39,735 

77,923 

1,232 

1,164 

2,396 

711 

577 

1,288 

1 

1 

2,452 

2,585 

5,037 

57 

64 

121 

1,661 

404 

2,065 

5 

1 

6 

31,935 

33,155 

65,090 

1,139 

1,088 

2,227 

439 

668 

1,107 

3 

12 

15 

13,298 

14,398 

27,696 

438 

457 

'  895 

1,994 

2,273 

4,267 

39 

36 

75 

1,970 

2,040 

4,010 

44 

51 

95 

6i'0 

164 

784 

1 

1 

9,907 

10,733 

20,640 

336 

288 

624 

1,260 

269 

1,529 

1 

1 

1,280 

1.096 

2,376 

14 

16 

30 

487 

89 

576 

48 

48 

1,769 

1,795 

3,564 

51 

53 

104 

314 

2 

316 

44 

44 

1,883 

1,883 

3,766 

58 

60 

118 

80 

34 

114 

33,489 

36,298 

69,787 

914 

923 

1,837 

352 

6 

358 

8,685 

8,865 

17,550 

260 

262 

522 

654 

2 

656 

14,290 

16,383 

30,673 

328 

312 

640 

451 

429 

880 

1 

1 

676 

5 

681 

14.490 

13,932 

28,422 

419 

425 

844 

347 

o 

349 

84 

3 

87 

19,842 

20,237 

40,079 

462 

447 

909 

326 

2 

328 

4,436 

4.226 

8,662 

124 

109 

233 

311 

311 

13 

13 

34,339 

35,788 

70,127 

1,082 

1,035 

2,117 

52 

50 

102 

1 

3 

4 

6,216 
828 

6.048 

12,264 

171 

164 

335 

4 

832 

18,407 

17,120 

35.527 

568 

587 

1,155 

11,391 

11.800 

23,191 

357 

315 

672 

3,365 

4.261 

7,626 

58 

71 

129 

6,382 

8,105 

14,487 

135 

170 

305 

153 

207 

360 

1 

1 

5,472 

7,358 

12,830 

80 

94 

174 

2,276 

3,435 

5,711 

35 

28 

63 

3,089 

5,448 

8,537 

38 

42 

80 

2,382 

4,692 

7,074 

48 

49 

97 

227 

489 

716 

16;541 

17,120 

33,661 

569 

591 

1,160 

968 

1,012 

1,980 

8 

7 

15 

16 

16 

10,301 

9,962 

20,263 

358 

319 

677 

686 

745 

1,431 

7 

15 

22 

359,679 

381,445 

741,124 

10,371 

10,187 

20,558 

12,625 

6,722 

19,347 

52 

56 

108 

1,231 

10 

1,241 

373,535 

388,177 

761,712 

10,423 

10,243 

20,666 

41 


aSTINGUISHING  THE  INMATES  OF  INSTITUTIONS  AND  SHIPPING ;  ALSO  NUMBER  OF  IRISH-BORN. 


1  4. 

5  9. 

10  14. 

15  19. 

j  Males. 

Females. 

Total. 

Males. 

Females. 

Total. 

Males. 

Females. 

Total. 

ilales. 

Females. 

Total. 

758 

775 

1,533 

1,005 

1,022 

2,027 

1,159 

1, 166 

>• 

2,325 

1,539 

1,579 

3,118 

11 

13 

24 

24 

13 

37 

10 

6 

16 

31 

21 

52 

903 

846 

1,749 

1    A  O  A 

1,030 

1,068 

2,098 

1,033 

1,042 

2,075 

Ij  170 

1, 146 

2,316 

72 

78 

150 

57 

A 

79 

136 

27 

40 

67 

39 

61 

294 

257 

551 

o  o  o 
332 

281 

613 

268 

313 

581 

J7b 

2  / 1 

547 

433 

471 

AA  4 

904 

522 

459 

991 

442 

405 

847 

1 

4D0 

460 

1 

AT  A 

910 

1 

1 

1 

6 

7 

4 

4 

8 

1 1 

34 

785 

803 

1,588 

o9d 

0*7  0 

873 

1,769 

784 

816 

1        A  A 

1,600 

o  1  y 

f7  £i  f* 

766 

1    c  o  er 

1,085 

3,946 

3,983 

T  A  .I  A 

4,4o6 

A    O  f*  ^ 

4,365 

8,851 

3,91  / 

4,055 

A  o 

7,9/2 

o,744 

3,991 

/,735 

24 

23 

4/ 

45 

25 

^7  A 

70 

186 

32 

218 

3o 

113 

262 

240 

502 

261 

268 

529 

221 

268 

A  OA 

489 

o  o  o 

238 

459 

o 

3 

2 

5 

12 

3 

15 

OA 

oO 

19 

99 

3,619 

3,644 

7,263 

4,004 

O    O  A 

3,8/9 

7,883 

3,487 

3,553 

7.040 

3,323 

6,554 

12 

18 

O  A 

60 

OA 

20 

27 

A  'T 

47 

194 

167 

361 

T  A 

19 

43 

62 

1  1,402 

1,412 

2,814 

1,613 

-1    f*  f\  A 

1,604 

3,217 

1,484 

1,464 

2,948 

1,36  / 

1,447 

2,814 

1  131 

159 

290 

191 

205 

396 

194 

215 

409 

224: 

250 

474 

170 

166 

336 

1  /  5 

216 

391 

214 

191 

405 

O  Af? 

207 

213 

420 

17 

10 

27 

47 

A  O 

48 

95 

46 

49 

95 

98 

O  A 

30 

128 

1,030 

1,074 

O    1  A  < 

2,104 

1,152 

1     1  PC  O 

1,152 

2,304 

A  A 

960 

1,11  / 

2,0/  / 

A  ^  A 

970 

1    A  PC  A 

l,OoO 

2,020 

1 

4 

5 

7 

9 

7 

5 

12 

35 

1 1 

46 

90 

88 

1  lb 

IIP; 
Ho 

101 

216 

96 

1  AfT 

107 

OA  O 

203 

111 
111 

1  1  A 

119 

r»  o  A 

230 

o 
O 

3 

7 

7 

46 

OA 

20 

66 

* '  * 

1 

1 

7 

7 

152 

167 

O  1  A 

319 

ley 

TOO 

183 

372 

166 

177 

343 

1  AA 

lyo 

168 

35o 

1 

1 

1 

1 

o 
0 

3 

2 

177 

185 

oo2 

1  O  i 

172 

356 

118 

161 

279 

153 

178 

331 

12 

12 

3,186 

3,166 

b,3o2 

O  K  1  ^ 
O,0l  ( 

3,o3d 

7,  loo 

o  K  o 

3,5o8 

O  A 

3,45  / 

/,015 

3,472 

3,634 

tr  1  A^ 

7,106 

2 

1 

1 

7 

9 

894 

980 

1,8/4 

1  A  Q  p; 

1  ATO 

1,079 

2,114 

A  O  O 

923 

8  /  3 

1,796 

O  O  Q 

8o8 

1,681 

1 

1 

4 

1 

5 

22 

1,111 

1,136 

2,247 

1,341 

2,683 

1,362 

1,347 

2.709 

1    PC  1  1 

1,51 1 

1,634 

3,145 

12 

7 

1  A 

24 

lb 

40 

29 

16 

45 

29 

54 

83 

1 

1 

54 

54 

1,353 

1,384 

o  oil 

2,737 

1  K  0  r. 

1    Pi  1  o 

l,Oib 

3,053 

1,449 

1,405 

2,854 

1,511 

4 

1,366 

2,877 
4 

1,594 

1,572 

o,lbb 

1    (\  A  ^ 

1,946 

O   A  1  1 

3,91 1 

1,875 

1    A  A  T 

1,997 

3,872 

cc 
0 

f)  f)  ^)  ^ 

2,145 

5 

4,367 

36 

36 

388 

409 

79/ 

A  Q  4 

4o4 

A  I"!  (\ 

4/9 

963 

432 

472 

904 

485 

432 

917 

1 

1 

o 

3 

3 

3,689 

3,708 

7,397 

4,189 

4,062 

8,251 

3,603 

3,563 

... 

7,166 

... 

3,473 

3,567 

7,040 

7 

2 

9 

8 

4 

12 

10 

9 

19 

5 

8 

13 

558 

529 

1  rt  u  ^7 

644 

boi 

1   o  A  p; 

1,305 

603 

639 

1,242 

631 

633 

1,264 

10 

1 

11 

1,903 

2,002 

O  A  A  K, 

1  A  ^ 
2, 1 41 

O  A  ^  A 

A    1  O  1 

4,181 

1,820 

1,934 

3,754 

1,812 

1,659 

3,471 

1,135 

1,113 

2,24o 

1,318 

1,246 

2,564 

],214 

1,170 

2,384 

1,154 

1,153 

2,307 

229 

227 

456 

310 

316 

626 

348 

329 

677 

O  A 

369 

501 

870 

571 

568 

1,139 

^1  A 

714 

708 

1,422 

637 

692 

1,329 

623 

917 

1,540 

6 

4 

10 

31 

27 

58 

40 

39 

79 

16 

26 

42 

395 

369 

764 

513 

498 

1,011 

529 

521 

1.050 

568 

884 

1,452 

146 

144 

290 

224 

200 

424 

237 

250 

487 

259 

459 

718 

152 

135 

287 

244 

226 

470 

267 

274 

541 

369 

591 

960 

173 

155 

328 

221 

242 

463 

214 

260 

474 

239 

431 

670 

1 

1 

2 

5 

7 

3 

38 

41 

1,872 

1,896 

3,768 

1,900 

1,899 

3,799 

1,630 

1,651 

3,281 

1,533 

1,558 

3,091 

101 

1  el's 

126 

/ 

^  i  o 

224 

i  i  J 

1,214 

2,334 

1  31  3 

1,271 

2,584 

1,149 

1.133 

2,282 

1,032 

2,086 

23 

19 

42 

18 

17 

35 

10 

6 

16 

15 

13 

28 

34,621 

34,977 

69,598 

39,745 

39,245 

78,990 

36.393 

37,017 

73,410 

36,780 

38,653 

75,433 

287 

274 

561 

411 

420 

831 

654 

600 

1.254 

785 

483 

1,268 

2 

... 

2 

105 

105 

34,908 

35,251 

70,159 

40,156 

39,665 

79,821 

37,049 

37,617 

74,666 

37,670 

39,136 

76,806 

42 


TABLE  II.- 


20  24. 

25  34. 

SANITARY  DISTRICTS. 

T^'pTTia  1  PR 

Total. 

ATa 1 pe 

n  PTn  £)  1p% 

Tntpl 

— 

BLYTHSWOOD,   

1    VVltllUUU  -LUoLlLUL'lUIlbj  ... 

1  TTi'=N't",Thnf,irtnci 

2,098 
56 

1.954 

64 

4,052 
120 

2,599 
86 

2,724 
63 

5,323 
14£ 

1. 

EXCHANGE  

1    VVlUXlUUb  J-UoL/luuDlUIlSj  ... 

1,464 

1.312 

2,776 

2,003 

1,939 

3,94? 

iiO  L/i-  L/  U.  UJ.'k-'XJ.Oj                 ...  ... 

30 

73 

103 

106 

141 

217 

2. 

PORT-DUNDAS,   

1  W/ 1  TrM'tTi'i'   Ssrn  tm^t  n  rr 

1  vviuiiuuu  tjiiippiii<^j  ... 

278 

263 

541 

453 

385 

83S 

\Shipping, ... 

5 

5 

7 

1 

3. 

HIGH  STREET  AND  CLOSES 

(Without  Institutions,  ... 

451 

392 

843 

717 

758 

1,47c 

WEST, 

I  TnstitntioTT^ 

40 

14 

54 

105 

58 

162 

4. 

ST.  ROLLOX,   

J  Without  Shipping, 

879 

818 

1,697 

1,413 

1,305 

2,716 

^^Shippmg, ... 

1 

1 

BELLGROVE  &  DENNISTOUN, 

I   VV  lUllUUU  XXlbLlLUljlOnSj 

l^lnstitutions,       ...  ... 

4,001 

4,074 

8.075 

6,719 

6,788 

13,50'i 

5. 

55 

121 

176 

85 

112 

m 

6. 

f  Wi  f",  n  mi  T.  Tn  cif",!  i",n  f,!  nn  a 

1     TV  LVJ.1\JKX  V    JlXIO  U±  U  Ul  UJ.VJXl0j         .  .  . 

243 

258 

501 

469 

461 

93C 

EAST 

1  XllouiuU.L'lULIbj            ...  ... 

153 

71 

224 

398 

145 

542 

7. 

y^A^ithout  Institutions, 

3,158 

3.308 

6.466 

5,411 

5,419 

10,83( 

ROAD, 

1  XIAO  U±  U  U.  uH_'J_Lo,               ...  ... 

42 

94 

136 

86 

180 

266 

8. 

BARROWFIELD,   

1,280 

1,373 

2,653 

2.072 

2,135 

4,207 

9. 

MONTEITH  ROW, 

249 

274 

523 

319 

348 

667 

10. 

ST.  ANDREW  SQUARE,  ... 

f  Without  Institutions,    . . . 

1  J.nbUitU.UlOllb.               ...  ... 

222 

223 

445 

323 

329 

655 

43 

7 

50 

81 

8 

8J 

11. 

CALTON  

J  Without  Institutions,    . . . 
I  TnRtitntTOTi*? 

1  -L  AAO  UA  U  W  UAv/AAO^                   ...  ... 

957 

1,030 

1,987 

1.624 

1,646 

3,27( 

51 

6 

57 

236 

31 

26'- 

^Without  Insts.  &  Shipping, 

175  , 

118 

293 

263 

170 

43: 

12. 

ST.  ENOCH  SQUARE, 

1   iTic'TTrn'l"!  /~m  o 
JLaJ  o  (jJL  UU  UlUiXo,            ...  ... 

64 

42 

106 

129 

21 

15( 

1  ftnTnTtiTio" 

1    kJ  LXA  1^  L^A  AA^:  .  ...                      ...  ... 

2 

■1 

18 

1^ 

z'  Vv  I'i'ririn't"  Xna't'c  ATSsrnnTM*n*Y 
J    VV  L  ullU  U- u  iXlo  uo.  136  Olll  IJ  UlJjy , 

191 

172 

363 

282 

279 

56] 

13. 

Institutions.       ...  ... 

15 

15 

70 

1 

7] 

1  SinTrniiTio* 

^KJAIA^^AAA^,  •  •  •                       ...  ... 

9 

9 

11 

1] 

14. 

BRIDGEGATE  AND  WYNDS, 

( W^ithout  Institutions, 

275 

200 

475 

390 

371 

76] 

1  TTT^tltntlOTl^ 

1  -A  AAo  UA  U  U.  UAv./AAo,                   ...  ... 

7 

3 

10 

10 

7 

r 

15. 

WOODSIDE  

f  Without  Institutions,    . . . 
\  Institutions,       . . . ,  ... 

3,670 
26 

3,873 

7,543 
26 

5,917 
78 

6,462 

12,37c 
li 

16. 

COWCADDENS,   

r^^itViont  Tri'^ititnl'.innci 

1      •  T    A  UAAV.f  lA  V    J.  AAO  UA  U  H  UA  wAAO,           .  .  . 

{^Institutions,   

920 
33 

856 

1,776 
33 

1,485 
144 

1,395 

2,88( 
14^ 

17. 

KELVINHAUGH  AND  SANDY- 
FORD, 

j  VVIUIIUUU  ±nb Lb, oiiipping, 
-I  Institutions, 

1,780 
58 

1,917 
100 

3,697 
158 

2,465 
92 

3,191 
156 

5,65( 
246 

i^oiiipping. . . . 

146 

146 

265 

5 

27( 

1  VV  iijnouD  ±nst3. 02  snipping, 

1.673 

1,456 

3,129 

2,549 

2,239 

4.786 

18. 

ANDERSTON 

A  Institutions,       ...  ... 

19 

1 

20 

71 

71 

I  Sh  ipping, ... 

10 

1 

11 

25 

21 

19. 

KINGSTON  

rW^ithout  Shipping, 

2,437 

2,285 

4,722 

3,552 

3,367 

6,9H 

Shipping, ...        ...  ... 

67 

67 

116 

2 

116 

1^  Without  Insts.  &  Shipping, 
"i  Institutions.       ...  ... 

555 

392 

947 

722 

614 

1,336 

T.ATT'RTF.STOW 

22 

L'2 

74 

74 

I  Shipping  

1 

1 

5 

c 

21. 

HUTCHESON  SQUARE, 

/Without  Institutions, 
^Institutions, 

3,508 
2 

3,669 
2 

7,177 

4 

6,014 
5 

6,090 

8 

12,101 
12 

22. 

GORBALS,   

(Without  Institutions,    . . . 

753 

650 

1,403 

1,102 

921 

2,022 

\lnstitutions, 

53 

53 

205 

1 

2oe 

C!PT?T'Nrr4P;nT?Kr  ^  PnPTTVTT  T  A 

2,109 

1,657 

3,766 

3,317 

2,727 

6,041 

r*  r^TT"  A  'MTTTT  T 

ItU  V  AJNIxlllili, 

1,206 

1,245 

2,451 

2,119 

2^179 

4,29? 

24. 

r!T?nSSHTT.T. 

...  ... 

395 

537 

932 

573 

821 

1,394 

25. 

LANGSIDE  &  MT.  FLORIDA, 

r^Vithout  Institutions, 

643 

885 

1,428 

1,149 

'1,607 

2,756 

\Institutions, 

11 

25 

36 

15 

49 

64 

-jU. 

POLLOKSHIELDS  &  STRATH- 

BUNGO,  

538 

868 

1,406 

887 

1,392 

2,279 

27. 

POLLOKSHIELDS,  WEST,  & 

BELLAHOUSTON, 

240 

691 

931 

308 

656 

964 

28. 

HILLHEAD,  

369 

937 

1,3U6 

524 

1,210 

1,734 

29. 

KELVINSIDE,   

/Without  Institutions,    . . . 
(Institutions, 

[Without  Insts.  ife Shipping, 

243 

890 

1,133 

381 

L,287 
67 

1,668 
1 1  9 

1,720 

1,860 

3,580 

3,240 

3,272 

6,512 

30. 

MARYHILL,  

-  Institutions, 

[shipping,  

196 

151 

347 

136 

188 

324 

8 

8 

6 

1,506 

/; 
0 

31. 

POSSILPARK  &  BARNHILL, 

(Without  Institutions,    . . . 

1,113 

992 

2,105 

1,643 

3,149 

(^Institutions, 

18 

35 

53 

54 

83 

- 

137 

Total  without  Institutions  and  Shipping, 

39,693 

41,429 

81,122 

63,004 

65,993 

128,997 

Total  Institutions,  ... 

1,013 

934 

1,947 

2,311 

1.319 

3,630 

Total  Shipping, 

249 

1 

250 

453 

7 

460 

Total  within  Municipal  Boundary, 

40,955 

42,364 

83,319 

65,768 

67,319 

133,087 

43 


'on  tinned. 


A        35  44. 

45  54. 

1          55  64.- 

1  13 OKN  IN 

i[ales. 

Females 

Total. 

Males. 

Females 

Total. 

Males. 

(Females 

Total. 

Males. 

Females 

Total. 



M. 

F. 

Tl. 

j Ireland. 

1,562 

1,858 

3,420 

1,246 

1,548 

1  2,794 



826 

1,062 

1,888 

431 

705 

1,  1  ou 

2 

2 

1,490 

55 

16 

71 

25 

10 

35 

13 

13 

8 

2 

1  0 

48 

1,337 

1,369 

2,706 

992 

1,041 

2,033 

585 

664 

1,249 

248 

418 

666 

1,147 

148 

95 

243 

159 

85 

244 

204 

158 

362 

274 

298 

'499 

306 

289 

595 

274 

211 

485 

128 

113 

241 

43 

79 

653 

3 

3 

4 

4 

5 

522 

576 

1,098 

376 

374 

750 

1 94 

273 

467 

103 

186 

2 

2 

588 

118 

43 

161 

108 

28 

136 

55 

23 

78 

127 

71 

198 

159 

990 

934 

1,924 

700 

661 

1  1,361 

369 

434 

803 

168 

229 

397 

1,544 

1 

1 

1 

1 

1 

1 

X 

1 

4,658 

4,885 

9,543 

2,990 

3,094 

6,084 

1,612 

2,032 

3,644 

854 

1,265 

1  1  9 

jJ,  lit/ 

29 

39 

68 

6,367 

63 

51 

114 

41 

39 

80 

39 

36 

75 

93 

103 

196 

} 

1 

'294 

332 

328 

660 

217 

239 

456 

]  12 

130 

242 

57 

91 

413 

434 

92 

526 

320 

48 

368 

185 

20 

205 

71 

3 

74 

491 

3,665 

3,876 

7,o41 

2,316 

2,484 

4,800 

1,262 

1.577 

2,839 

639 

1,002 

i  J  U±  i 

A 

2 

« 

•  5,384 

46 

72 

118 

14 

36 

50 

2 

15 

17 

1 

4 

Fa 
O 

85 

1,566 

1,788 

3,3o4 

l,lo8 

1,259 

■2,417 

-no 

o99 

881 

1,480 

316 

578 

O  t: 

O 

o 

2.783 

261 

307 

568 

201 

232 

433 

106 

150 

256 

78 

96 

1  74- 

1 
i 

1 

X 

0 

336 

286 

253 

539 

173 

180 

353 

109 

139 

348 

47 

79 

1  O 
1^0 

514 

133 

5 

138 

96 

98 

46 

3 

49 

13 

1 

1  A 

144 

1,279 

1,374 

2,653 

865 

936 

1,801 

510 

652 

1,162 

224 

413 

do  t 

1 

1  937 

369 

55 

424 

304 

59 

363 

175 

54 

229 

79 

37 

LID 

360 

185 

144 

329 

120 

111 

231 

75 

77 

152 

36 

45 

o  1 

315 

104 

6 

110 

82 

-•• 

82 

41 

41 

11 

1  1 
i  1 

139 

7 

7 

7 

7 

6 

6 

3 

o  o  o 

23o 

240 

473 

198 

172 

370 

90 

1 1 9 

209 

27 

65 

673 

68 

68 

89 

89 

46 

46 

21 

o  1 
-J  1 

83 

11 

1 1 

10 

10 

1 

1 

4 

OOfi 

A  o  r* 

4oD 

147 

165 

312 

83 

101 

184 

41 

61 

1  no 

515 

15 

Q 
O 

26 

14 

7 

21 

17 

8 

25 

5 

1 

0 

39 

\  A  TOO 

t  4, 192 

4,0ol 

Q  'T.JO 

0,7  Jo 

a  o  OA 

J,o20 

O   1  AA 

0,190 

6,010 

1,506 

2.075 

3,581 

735 

1,347 

9  08  o 

2 

A 

tt 

a 

D 

3  930 

90 

1 

9o 

O  1 

81 

81 

51 

51 

14 

1  ^ 

60 

!  1;U94 

1,104 

2,19i^ 

/ 18 

735 

1,453 

391 

464 

855 

142 

258 

L 

1 

id, 00  1 

loO 

loL) 

1  f:  o 

loo 

1 

154 

83 

83 

34 

o-± 

xoo 

1,  /  9o 

/,14J 

1  o  1  f; 
1,010 

1,577 

2,892 

863 

1,060 

1,923 

420 

725 

1,  ittO 

1 

1 

0  / 

OO 

loo 

00 

Ci  A 
24: 

90 

39 

16 

55 

14 

5 

1  Q 

1  y 

1  64 

loi 

i  Jl 

52 

52 

21 

21 

5 

0 

1 

1 

44 

1,  /  /o 

1,01 6 

o,4oi 

1  OOO 

l,2o8 

1,248 

2,486 

691 

790 

1.481 

292 

426 

1  lo 

■-) 

0 

A 
t 

4  400 

I  A  A 

104 

A  1 

91 

1 

92 

42 

42 

16 

1  0 

1  -^Q 

O  T 

Al 

1 

Y  V 

lo 

1 

14 

8 

8 

1 

1 

1 

1 

.J  1 

4,o4y 

.i,4iD 

4.7oo 

1,700 

1,927 

3,682 

1,129 

1,359 

2,488 

518 

755 

1 ,  J  /  o 

0 

0 

0 

9  8*^4 

^  A 

04 

o9 

39 

13 

13 

1 

1 

41 

K  Q 
OoO 

L,Ul  6 

42o 

383 

806 

204 

261 

465 

79 

140' 

0  1  Q 

0 

0 

1  ,  i  D  i/ 

oJ 

/  7 

77 

37 

37 

15 

]  f: 
1  0 

70 

2 

2 

2 

o 

2 

2 

1 

1 

4,080 

4,231 

8,311 

2,642 

2,879 

5,521 

1,417 

1,824 

3.241 

■  642 

1,160 

1,802 

5,848 

7 

7 

14 

4 

3 

7 

o 

3 

6 

1 

1 

10 

787 

768 

1,555 

517 

545 

1.062 

318 

367 

685 

132 

171 

303 

1,722 

i 

O  O  1 

-i  24 

lyb 

1 

197 

99 

99 

42 

1  0 

A  A 

222 

4,1  DO 

1  OOA 

i,yy(j 

A  1  f;  f: 
4,  loo 

1     A  O  X 

l,4ho 

1,320 

2,805 

750 

772 

1,522 

337 

432 

1  by 

^,  OOo 

1  'i.-XA 

1,4:00 

J,  <  (  U 

ob/ 

AO/? 

986 

1.853 

476 

-  578 

1.054 

210 

379 

Ooy 

1 

1  1 
1 

y  o-i 

■i-iO 

00/ 

9bo 

O  O 

3o2 

437 

769 

205 

286 

491 

120 

179 

OOO 

-lyy 

01  f; 

O  /  O 

1  AQ  f; 

1  0 

K  O  O 

592 

613 

1.205 

322 

487 

809 

218 

363 

Oo  1 

8 

22 

30 

15 

11 

26 

5 

2 

7 

5 

o 

7 

AX) 

i  yo 

1  A7  f; 
1,<J/  0 

1    Q  ^?  Q 

1,od6 

576 

728 

1,304 

358 

483 

841 

235 

446 

DOl 

266 

238 

392 

630 

274 

306 

580 

192 

189 

381 

123 

120 

243 

155 

4^U  i 

/  DO 

1,1/0 

O  o 

od2 

K  p;  .1 

502 

914 

210 

405 

615 

147 

307 

454 

1 

-1  1 

1  1 

186 

£J  9  Q 
000 

954 

244 

376 

620 

196 

21  7 

413 

J02 

152 

2Di 

1  Rd 

1  by 

57 

61 

118 

38 

88 

126 

41 

57 

98 

22 

47 

69 

4o 

2,037 

2,071 

4,108 

1,184 

1,239 

2,423 

597 

684 

1,281 

259 

399 

658 

4,363 

68 
1 

71 

139 
1 

23 
1 

15 

38 
1 

17 

10 

27 

5 

5 

154 

1,186 

1,143 

2,329 

796 

740 

1,536 

433 

400 

833 

136 

212 

348 

4 

2,001 

75 

77 

152 

119 

82 

201 

141 

128 

269 

206 

270 

476 

346  i 

43,835 

47,010 

90,845 

30.113 

32,488 

62,601 

16,918 

21,105 

38,023 

8,159 

13.283 

21,442 

47 

58 

105 

62,274 

2.539 

718 

3,257 

2,115 

540 

2,655 

1,381 

533 

1,914 

1,076 

845 

1,921 

1 

1 

3,708 

231 

1 

232 

128 

1 

129 

52 

52 

9 

9 

2 

o 

124 

46,605 

47,729 

1 

94,334 

32,356 

33,029 

65,385  1 

18,351 

21.638 

39.989 

9,244 

14,128 

23,372 

50 

58 

108 

66,106 

44 


TABLE  III.— CENSUS,  1901— GLASGOW  :  AGE  AND  SEX  OF  THE  INMATES  OF  INSTITUTIONS  WIT] 


All  Ages. 

SANITARY  DISTRICTS. 

Name  of  Institution". 

0 

r* 

Hotel, 

127 

80 

Hotel,   

29 

48 

BLYTHSWOOD,   j 

Y.M.C.A.,  100  Bothwell  Street,   

Sick  Children's  Hospital, 

121 

44 

13 
70 

City  Poorhouse,  ... 

863 

804 

L 

1 

EXCHANGE                              ...        ...  ] 

{ 

HIGH  STREET  AND  CLOSES  WEST,  ...  j 

Fever  Hospital,  Kennedy  Street, 

ine  JNight  Asylum  tor  txie  Houseless,  ... 

Old  Man  s  Home  and  Asylum  tor  Old  W  omen. 

Lodging-House,  173  High  Street, 

94 
164 
12G 
168 

204 
90 
75 

3 

I 

Do.,        195-207  do.,  

1 

145 

Do.,       34  Stirling  Street, 
Central  Jrohce  Omce, 
Slatefield  Industrial  School, 

192 
95 
175 

3 

35 
2 

Glasgow  Royal  Infirmary, 
tet.  0  oseph  s  Home, 
Old  Barracks,  Gallowgate. 
Drygate  Model  Lodging-House. 
xi.  M.  Irrison,  Duke  htreet, 
Lodging-House,  48  Duke  Street. 

375 

363 

5 

BELLGROVE  AND  DENNISTOUN,        ...  | 

f 

104 
57 
365 
105 
206 

137 
75 
4 

314 
1 

6 

HIGH  STREET  AND  CLOSES  EAST,  ...  ' 

f 

Do.,          39  Watson  Street,   

352 

Do.,          21  do.. 

Do.,          14-16  do.,   

Home  tor  friendless  remaies,  h  Watson  Street, 
Catholic  Orphanage  tor  Boys,  ... 

519 
111 
3 

205 

1 

84 
5 

7 

GREENHEAD  AND  LONDON  ROAD,     ...  J 

[ 

Do.           do.            Girls,  ... 

T-">    1     •  ^           xn              XX         •  j_  1 

Belvidere  i  ever  Hospital, 
City  Orphan  Home, 

234 

88 

208 
455 
35 

10 

ST.  ANDREW  SQUARE,   j 

( 

Lodgmg-House,  4o-49  Greendyke  Street, 
Family  Home,  St.  Andrew  Street, 

T        1     •           TT                 /Tn             l\ul/^"I\r                     CIJ.  J- 

Lodgmg-House  (female),  20  Moncur  Street,  ... 

282 
250 
4 

4 

125 
263 

11 

CALTON  i 

I 

Do.,         0  0  Moncur  otreet. 

193 

Do.,         i<y  Ijrreat  Manulton  street,  ... 
Do.,         58-o2  Clyde  btreet. 

700 
363 

6 

12 

James  W^att  Street  Home,  22  James  Watt  St., 

377 

2 

ST.  ENOCH  SQUARE,   I 

Hotel,   

110 

87 

] 

13 

BROWNFIELD,   

Model  Lodgmg-House,  28  M'Alpme  Street,  ... 

314 

2 

14 

BRIDGEGATE  AND  WYNDS,   

Lodging-House,  6-14  Miller's  Place, 

80 

34 

] 

15 

WOODSIDE,    ;  

Lodging-House,  51  North  VVoodside  Koad. 

352 

6 

16 

COWCADDENS,   -f 

f 

Lodging-House,  1  Burns  Street, 

399 

2 

4 

Do.,          16  Garscube  Lane, 

255 

c 

Western  Infirmary, 

253 

382 

( 

17 

KELVINHAUGH  AND  SANDYFORD,    ...  | 

Eye  do.,   

65 

46 

] 

Clydesdale  Model  Lodging-House,  Cheapside  St., 

133 

1 

] 

1  O 

ib 

ANDERSTON,   

Hydepark  Model  Lodging-House, 

347 

2 

20 

LAURIESTON  

XT"  ■         J        "ft  /r    1  1  X     1    *        TT      „  „ 

Kingston  Model  Lodging-House, 

311 

21 

HUTCHESON  SQUARE,  

Sanitary  Reception-House,        ...  ... 

52 

"50 

] 

GORBALS  1 

Carlton  Model  Lodging-House  

A 

41 

22 

Portugal  Street  Model  Lodging-House, 

425 

4 

4 

25 

LANGSIDE  AND  MOUNT  FLORIDA,    ...  / 

I 

Victoria  Infirmary. 

iyeai  aiiu.  jL'u.mu  ±iiauituuiuii,      ...         ...  ... 

87 
66 

131 
76 

] 

29 

KELVINSIDE,   | 

Training  College, 

160 

] 

Royal  Asylum,  Gartnavel, 

227 

329 

P 

Girls'  Industrial  School,... 
Magdalene  Institution,  ... 

200 
102 

(T 
A 

1 

30 

MARYHILL,   - 

Eastpark  Home,  ... 
Maryhill  Lodging-House, 
Ruchill  Fever  Hospital, ... 

"44 

98 

65 
4 

1 
1 

269 

497 

7 

Government  Barracks,  ... 

557 

144 

7 

31 

POSSILPARK  AND  BARNHILL, 

Barnhill  Poorhouse, 

686 

745 

1,4 

Total  within  Municipal 

Boundary,         ...       ...       ...       ...       ...  | 

12,625 

6,722 

19,3 

45 


L'HE  CITY;  ALSO  NUMBER  OF  IRISH-BORN,  AND  NUMBER  OF  WINDOWED  ROOMS  IN  EACH. 


Under  1 

Year. 

1  

-4. 

5 

-9. 

in  

14. 

id 

19. 

20- 

■24. 

cu 

m 

0) 

'a 

CO 

Is 

M 

Is 

"Is 

Is 
a 

<D 

Is 

Is 

a> 
"ce 

+3 

i 

o 

i 

0 

1 

0 
C— 1 

0 

S 

0 

<i 

S 

0 

1  ^ 

1 

... 

2 

1 

3 

1 

1 

2 

16 

14 

30 

21 

31 

52 

1 

1 

... 

1 

1 

1 

3 

4 

3 

16 

19 

2 

2 

14 

14 

31 

3 

34 

2 

3 

5 

11 

13 

24 

22 

11 

33 

7 

4 

11 

4 

4 

1 

14 

15 

16 

11 

27 

34 

32 

66 

26 

27 

53 

16 

16 

32 

10 

25 

35 

18 

37 

55 

3 

3 

36 

42 

78 

27 

47 

74 

10 

20 

30 

7 

14 

21 

5 

35 

40 

3 

1 

4 

2 

4 

6 

4 

5 

9 

1 

4 

5 

5 

5 

7 

1 

8 

3 

3 

5 

5 

"1 

1 

1 

1 

8 

8 

2 

2 

1 

1 

5 

5 

3 

"3 

6 

6 

7 

7 

1 

1 

3 

1 

4 

5 

1 

6 

10 

10 

1 

1 

17 

1 

18 

22 

2 

24 

1 

1 

2 

7 

"7 

142 

142 

21 

21 

2 

2 

1 

1 

16 

8 

24 

31 

19 

50 

36 

23 

59 

50 

23 

73 

48 

109 

157 

3 

3 

"7 

14 

21 

7 

6 

■'13 

8 

9 

"17 

7 

12 

19 

5 

9 

14 

1 

1 

4 

1 

5 

25 

25 

3 

1 

4 

1 

1 

12 

14 

26 

35 

65 

100 

1 

1 

1 

1 

31 

31 

29 

29 

1 

1 

4 

4 

18 

18 

34 

34 

1 

1 

6 

6 

14 

14 

-7 

27 

1 

1 

3 

3 

2 

2 

2 

2 

■1 

2 

4 

4 

6 

6 

1 

1 

11 

11 

189 

189 

0 

1 

3 

18 

18 

152 

152 

25 

25 

3 

12 

15 

12 

17 

29 

9 

9 

18 

5 

15 

20 

17 

17 

34 

42 

94 

136 

8 

3 

11 

70 

17 

87 

6 

5 

11 

1 

1 

9 

•1 

11 

23 

23 

1 

1 

17 

9 

26 

47 

48 

95 

38 

46 

84 

19 

11 

30 

14 

2 

16 

1 

1 

1 

3 

4 

2 

6 

8 

4 

4 

11 

11 

5 

5 

4 

4 

18 

18 

16 

16 

3 

3 

10 

10 

16 

16 

1 

1 

1 

1 

1 

1 

7 

7 

19 

1 

20 

... 

3 

3 

6 

6 

24 

1 

25 

37 

37 

1 

1 

22 

19 

41 

27 

42 

69 

1 

1 

2 

1 

1 

3 

3 

15 

15 

12 

12 

7 

3 

10 

2 

2 

1 

1 

7 

2 

9 

26 

26 

1 

1 

4 

1 

5 

20 

20 

22 

22 

2 

2 

11 

11 

1 

1 

12 

7 

19 

16 

10 

26 

25 

11 

36 

18 

51 

69 

32 

89 

121 

7 

6 

13 

3 

5 

8 

6 

3 

9 

12 

11 

23 

1 

1 

1 

1 

5 

5 

14 

14 

4 

4 

19 

1 

20 

1 

1 

3 

3 

2  2 

22 

1 

3 

4 

7 

2 

9 

8 

4 

12 

10 

9 

19 

5 

8 

13 

2 

2 

4 

7 

7 

25 

25 

3 

1 

4 

28 

28 

1 

6 

4 

10 

10 

9 

19 

0 

/ 

12 

si 

1  f\ 

IV 

18 

11 

23 

34 

21 

18 

39 

35 

32 

67 

8 

16 

24 

2 

2 

4 

4 

31 

31 

93 

93 

1 

1 

2 

1 

3 

3 

7 

10 

19 

32 

51 

13 

13 

150 

150 

27 

27 

36 

36 

22 

22 

28 

28 

56 

15 

16 

7 

7 

4 

4 

1 

1 

2 

1 

3 

5 

5 

1 

2 

3 

68 

69 

137 

78 

83 

161 

35 

40 

75 

24 

38 

62 

23 

110 

133 

7 

5 

12 

33 

25 

58 

20 

23 

43 

14 

10 

24 

198 

3 

201 

168 

15 

183 

7 

15 

22 

23 

19 

42 

18 

17 

35 

10 

6 

16 

15 

13 

28 

18 

35 

53 

52 

56 

108 

287 

274 

561 

411 

420 

831 

654 

600 

1,254 

785 

483 

1,268 

1,013 

934 

1,947 

46 


TABLE  III.- 


25  

34. 

SANITARY  DISTRICTS. 

Name  of  Institution. 

oi 

Q 

Females. 

c 

( 

Hotel,   

40 

65 

BLYTHSWOOD,  

Hotel,   

Y.M.C.A.,  100  Bothwell  Street,   

10 

14: 

24 

■  \ 

35 

O 

41 

[ 

Sick  Children's  Hospital, 

1 

18 

19 

City  Poorhouse,  ... 

58 

O  1 

145 

1 

EXCHANGE,   

.  J 

Fever  Hospital,  Kennedy  Street, 

4 

Q^? 
•DO 

40 

I 

The  Night  Asylum  for  the  Houseless,  ... 

44 

1  ft 

io 

62 

Old  Man's  Home  and  Asylum  for  Old  W^omen, 

Q 

9 

Lodging-House,  173  High  Street, 

29 

29 

3 

HIGH  STREET  AND  CLOSES  WEST,  . 

Do.,          195-207  do.,   

Do.,          34  Stirling  Street, 
Central  Police  Office,     ...        ...        ...    _  ... 

Slatefield  Industrial  School,      ...        ...      •  . . . 

49 
27 

27 

T 
1 

27 
49 
49 
1 

5 

BELLGROVE  AND  DENNISTOUN, 

\ 

Glasgow  Royal  Infirmary, 

"76 

i/O 

171 

■  1 

St.  Joseph's  Home,        ...        ...        ...  ... 

4 

4 

I 

Old  Barracks,  Gallowgate, 

9 

1 1 

21 

f 

Drygate  Model  Lodging-House, 

105 

I 

106 

H.M.  Prison,  Duke  Street,   

30 

153 

Lodging-House,  48  Duke  Street. 

4b 

46 

6 

HIGH  STREET  AND  CLOSES  EAST,  . 

Do.,          39  Watson  Street,   

79 

79 

Do.,         21  do.,   

112 

i 

113 

Dn              14  16  Hn 

•^6 

OR 

r 

Home  for  Friendless  Females,  8  Watson  Street, 
Catholic  Orphanage  for  Boys,  ... 

2 

oo 
Ik) 

20 
2 

7 

GREENHEAD  AND  LONDON  ROAD,  .. 

. 

Do.            do.           Girls.  ... 

0 

5 

1 

Belvidere  Fever  Hospital, 

84 

175 

259 

10 

f 

City  Orphan  Home, 

2 

■i 

6 

ST.  ANDREW  SQUARE, 

i 
■  1 

Lodging-House,  4-5-49  Greendyke  Street, 
Family  Home.  St.  Andrew  Street, 
Lodging-House  (Female),  20  Moncur  Street,  . . . 

56 
23 

4 
30 

56 
27 
30 

11 

CALTON,  

J 

Do..         66  Moncur  Street. 

43 

43 

•  i 

Do.,         179  Great  Hamilton  Street,  ... 

122 

122 

1 

Do.,         58-52  Clyde  Street,   

71 

I 

72 

LI 

ST.  ENOCH  SQUARE,  

James  Watt  Street  Home,  22  James  Watt  St., 

100 

1 

101 

•  \ 

v 

Hotel,   

90 

u 

20 

49 

13 

BROWNFIELD,   

Model  Lodging-House,  28  M  Alpine  Street, 

70 

1 
1 

71 

14 

BRIDGEGATE  AND  WYNDS,     ...     '  . 

Lodging-House,  6-14  Miller's  Place, 

10 

/ 

17 

15 

WOODSIDE,   ,. 

Lodging-House,  5 1  North  W^oodside  Road, 

78 

78 

16 

COWCADDENS,   

'  / 

Lodging-House,  1  Burns  Street. 

QQ 
w 

99 

■  \ 

Do.,          16  Garscube  Lane, 

45 

45 

17 

Western  Infirmary, 

53 

147 

200 

KELVINHAUGH  AND  SANDYFORD, 

j 

Eye  do.. 

Q 

t? 

8 

17 

18 

■  1 

Clydesdale  Model  Lodging-House,  Cheapside  St., 

oyj 

1 

31 

ANDERSTON,  

Hydepark  Model  Ijodging-House, 

71 

71 

20 

LAURIESTON,   

Kingston  Model  Lodging-House, 

74 

74 

21 

HUTCHESON  SQUARE  

Sanitary  Reception-House, 

5 

8 

13 

22 

GORBALS,  

'  f 

Carlton  Model  Lodging-House,... 

98 

98 

I 

Portugal  Street  Model  Lodging-House, 

107 

1 

108 

25 

LANGSIDE  AND  MOUNT  FLORIDA,  . 

■{ 

Victoria  Infirmary, 

13 

45 

58 

Deaf  and  Dumb  Institution, 

2 

4 

6 

29 

KELVINSIDE,   

■{ 

Training  College,  ... 
Royal  Asylum,  Gartnavel, 
Girls'  Industrial  School, ... 
Magdalene  Institution,  ... 

22 

22 

45 

45 

90 

4 
20 

4 
20 

30 

MARYHILL,  ...   

Eastpark  Home,... 

1 

7 

8 

.  - 

Maryhill  Lodging-House, 

24 

1 

25 

Ruchill  Fever  Hospital, ... 

27 

110 

137 

Government  Barracks,  ... 

84 

46 

130 

31 

POSSILPARK  AND  BARNHILL, 

Barnhill  Poorhouse, 

54 

83 

137 

Total  within  Municipal 

Boundary, 

2,311 

1,319 

3,630 

47 


ntinued. 


0 

45  54. 

ftS  64 

65  AND  Upwards. 

Not 

Known. 

35  44. 

P5 

H  . 

c  S 

Males. 

Is 

s 

CD 
0) 

B 

rv. 

0 
H 

W 
0) 

w 

s 

0 
H 

w 
0) 

s 



"3 

m 
"cS 

<a 

Is 
+^ 
0 

EH 

h-t 

"A 

'A 
« 

w 

27 

6 

33 

12 

1 

13 

1 
-t 

4 

4 

1 

5 

21 

379 

7 

6 

13 

1 

6 

7 

5 

5 

1 

3 

18 

91 

21 

2 
2 

23 
2 

12 

9 
1 

14 
1 

4 

4 

2 

2 

2 
7 

208 
93 

104 
1 

70 
6 

174 
7 

131 

65 
2 

196 
2 

183 
1 

139 

2 

322 
3 

267 

295 

562 

426 
10 

256 
122 

43 

19 

62 

28 

18 

46 

20 

17 

37 

7 

3 

10 

03 

57 

2 

2 

2 

2 

13 

2 

15 

113 

52 

165 

18 

77 

53 

1 

54 

50 

50 

20 

20 

7 

7 

05 
16 

5 

33 

33 

23 

23 

20 

20 

19 

19 

18 

"50 

50 

49 

1 

50 

18 

18 

7 

7 

36 

33 

15 

7 

22 

9 

11 

4 

1 

24 

83 

1 

1 

i 

1 

9 

32 

56 

39 

95 

36 

26 

62 

20 

15 

35 

5 

6 

11 

93 

206 

5 

5 

8 

8 

17 

20 

37 

87 

97 

184 

190 

48 

6 

7 

13 

5 

5 

10 

2 

1 

.3 

1 

1 

0 

60 

103 

103 

74 

1 

75 

42 

42 

12 

12 

149 

16 

13 

71 

84 

8 

28 

36 

2 

11 

13 

1 

1 

2 

65 

643 

39 

1 

40 

29 

29 

25 

25 

5 

5 

37 

15 

85 

85 

71 

71 

39 

39 

21 

21 

00 

8 

165 

165 

109 

109 

59 

59 

26 

26 

134 

8 

29 

29 

28 

28 

18 

18 

6 

6 

33 

4 

20 

20 

1 

1 

19 
2 

20 
3 

9 

9 

2 
1 

2 
1 

7 
14 

27 
21 

3 

3 

2 

2 

2 

2 

1 

1 

14 

29 

46 

69 

115 

13 

32 

45 

2 

13 

15 

1 

2 

3 

57 

327 

1 

3 

4 

1 

1 

1 

1 

2 

1 

1 

1 

52 

87 

1 

88 

63 

63 

34 

34 

10 

10 

122 

12 

45 

1 

46 

33 

1 

34 

11 

2 

13 

3 

3 

21 

176 

54 

54 

59 

59 

54 

54 

37 

37 

43 

14 

38 

38 

30 

30 

29 

29 

15 

15 

42 

11 

n9 

219 

188 

188 

98 

98 

44 

44 

155 

11 

[12 

1 

113 

86 

86 

48 

48 

20 

20 

120 

12 

93 

93 

65 

65 

39 

39 

10 

10 

103 

16 

11 

6 

17 

17 

17 

2 

2 

1 

1 

36 

282 

68 

68 

89 

89 

46 

46 

21 

21 

H3 

16 

15 

8 

23 

14 

"'7 

21 

1  7 

J.  1 

8 

25 

5 

1 

6 

39 

12 

95 

1 

96 

81 

81 

51 

51 

14 

14 

60 

11 

.08 

108 

83 

1 

84 

41 

41 

21 

21 

74 

10 

72 

70 

70 

42 

42 

13 

13 

64 

9 

49 

33 

82 

30 

19 

49 

12 

12 

24 

5 

3 

8 

80 

381 

6 

2 

8 

8 

5 

13 

9 

4 

13 

5 

2 

7 

13 

65 

32 

32 

28 

28 

1  0 

1  8 

4 

4 

71 

7 

.04 

104 

91 

1 

92 

42 

42 

16 

16 

129 

17 

^82 

82 

77 

77 

37 

37 

15 

15 

70 

12 

7 

"'7 

14 

4 

3 

7 

3 

3 

6 

1 

1 

10 

19 

i.02 

Q9 

Q9 

59 

59 

20 

20 

104 

12 

i.21 

1 

122 

104 

1 

105 

40 

40 

22 

22 

118 

24 

8 

19 
3 
6 

27 
3 
6 

15 

11 

3 

26 
3 

5 

1 
1 
1 

6 
1 
1 

5 

2 

7 

24 
2 

32 

206 
68 
94 

57 

55 
3 

21 
2 

112 
3 
21 

2 

38 

85 
2 
2 

123 
2 
2 

41 

56 
1 
1 
1 

97 
1 
1 
1 

22 

"47 

"69 

16 
3 
7 
3 

347 
70 
23 
46 

30 

30 

15 

1 

16 

"17 

17 

5 

5  1  ... 

33 

10 

:  9 

32 

41 

4 

7 

11 

6 

6 

53 

415 

29 

13 

42 

4 

3 

7 

1 

1 

55 

284 

75 

77 

152 

119 

82 

201 

141 

128 

269 

206 

270 

476 

346 

85 

:i39 

718 

3,257 

2,115 

540 

2,655 

1 1,381 

533 

1 

1,914 

'1,076 

845 

1,921 

1 

1 

3,708 

5,695 

48 


02 

O 

X! 


o 

I— I 

<1  ,  . 

^  r 
O  02 

H  O 


O 

I— ( 
Er 

o 

m 
O 


P5 

m 
m  M 

P3 


<t1 
H 

I— I 


H 
I— I 

m 

W 

O 


I— I 


Ph 

o 


o 

1—1 
H 

H 
H 

<J  I— I 


^  W-l 

o  H  M 

2  H  H 

m  M  O 

o  W 

I  H  Ph 

I  M 

>  ^  K 

<s 


CM 


o 

(M 


O  —  Ol  so 


•saT'BtU3^g; 


cc  CO  t/:i  o  ^     cc         Ci  o 
:r=0>»O>0t^     co-+cci-'0  CiOlccoj^ 
-ti'^'^Hipcp     MC305m(>j  pcpror^^^ 


Tt<         C»  -H  tH 

O  -* 
G5  CI  03  TtH  r-t 


00  Ol  — I 

01  CI  CO  O  <M 
C-J  — I  O  C3  -*< 


— I  O  <35  O  — I 
O  C5  cr>  -H 
"O  O  C3  CO  CO 


lO  O  I—  00  G2 


o  o  CO 

o     ira  o  00 

O  O  CI  ^  »^ 


O  00  O  CO  -H 
O       ira  OI  o 

lo  00  oi 


CO  -H  o  o  o: 
CO  CO      o  o 

05  O I  -T<  XJ  "P 

o  o     o  o 


CO  (M  O  T(<  C5 
Ol  CO  O  CO  CO 

lo  CI  CO  to  CO 


—  1^  Ol  CO 
O)  O  LO  O  03 

c-l  00  p  CO  CI 

C-1  C5  O  CO  ifO 


C)  C3  lO  O  CO 
-+  O  c^  O  I- 

O        t-  ^  C5 


CO  o  CO  CO  ira 
-H  CO  00  CO  -rti 

O  CO  CO  O 


r-<  1.0  lO 

00  CI  C2  Ol  00 
"Q  lO  GO  00  O 


eoic-(<Ti(m     lO'Cio-^co     io-*-*Tt<m     o-<*icoioio     t)<ioi-ot)<io     c-cococio  C)"0-*-*o 


C3  ^  O  C5  »• 

CO      (M  O  <M 
lO  C)  lO 


>0  lO  CI  (M  CO 

CO  (M  LO  C4  CC, 
■-^  00  GO  CO  00 


CO  CO  05  CI 
CO  CO  CO  >o  O 
lO  CO  CO  CO  CO 


O  C4  CO  CO 

lO  t(<  O  00  (73 
CI  !M  CO  CO  O 


(M  o  CO  o 
O  O      CO  o 

O  — I  C3  C) 


05  00        C)  CI 
Ttt  C5  O  C) 
^      ^  (M  CO 


"C  o  CO  CO 

CO  -H  05  CO  CO 
Tt<  ^  -f  CJ  O 


CO  lo  lo  »o     in     -ti     m     ira     t-  lo        m  lo  lo  o  co     co  >o  co  m  lo     o  co  -* 


C5  1^  o  o  t-- 
(M  CI  1^  O  CO 

I        ©1  CO  03 


CO  CO  C3  O  C. 
CI  —I  CO  CO  o 
C5        O  -H 


t-^  O  LO  o 
CO  00  CO 
TtH-~  CO  O 


Ol  CO  CO  CI  CO 

oo     lo  CI  o 

lO  CI  oo 


Oi  1^  o  00 

CO  CO  O  I  -  M 

LO  O  CO  C5 


c/)  o     101  ira 

O  CO  —  -)< 

CO  CO  LO  CI 


— I  CO  lo  .-H 
CC  o;  lo  CO 

r-H  CI  IQ 


1— IOOOC3  C5C500-H 


O  C3  03  O  00 


0C5  0  00  OOOCiCJ 


G:  G5  o  CO  oo 


■sal's 


•sa|'Bi\[ 


coojOTrtt^  c^LOLO'Co  cit^oo-*co  r-C3i—  cool  t^r^iMOd  ooot— co 

COLOOO-^^  CJCIOC^IlO  ^OOO— <CJ  OOOCIOira  OOOOCOl^I-^  t^COCTiCOOl 

O-Tipoicjo  r-Ht-^r-icico  coopt^t;-  cioocoooco  o>p.^pp  ipcocoop 

lOlOlOlOr+t  lO'cHIOtOlO  ^bL:)>0'rt^T^^  IOt+HIC-^LO  Tt<lOU0'<:t^"*  coocooocb 


CO  C3  CO 
c:  01  O  CO 

O  CO  C  '  Tt< 


CO  00  CI  CO  o 
05  CD  CO  C3  LO 
C-l  f-H  O  —I 


^  CO  -<<  lO  o 
O  oo  CO  CO  IC 
00  CO  Cj3  C3  d 


>ra  lo  lO  o  ira     -t<  Tft  Tt<  -cH  LO 


c^  o  CI  — I  CO 

CD  O       CO  CO 
l;-  p  P5  p 
LO  LO  -* 


ira  C3  CO  CD  Tt( 

1^  00  0-1  — <  Tj( 

p  p  p  CO  "O 

I'o  LO 


O  CI  LO  O  CO 

o  ira  ^  o 
p  p  —  71  p 

10  -*  10  LO  -f 


CO  O        LO  CI 

CO  o  c)  CO  01 

CO  CO  --t<  LO  CO 


00  -nJH  CI  1-  > 

LO  O  LO  CD 
CO  10  CI  O 
CC  -H  LO  C)0 


•S81TJH 


C5  CI  C2  10  — I 

0  ^  O  CO  CO 

01  CO  03  LO  O 


-H  CO  CO  -f  LO 

CO  O  '  CO 
C4       CO  CO  UO 


O  CO  CO 
O  CO  -*  Ol  o 
1  O  10  CD  'I' 


01  CI  —  ^ 
LO  CO  CO  -f  CO 
O  C)  CO  O  CO 


CD  C5  1-^  O 
CO  —I  01  CO  CO 
-ft  CI  — .  LO  Ol 


t  1<  -*  X  t-^ 

I—      CO  01  CO 

00  r-^  10  CO 


~       CI  CI  ^ 
O        CO  CO  CO 
CI  — 


C0030C50     O03OOC3     ooocc5t^     OOCOOC3  00000 


GOC300COCD  CDOS^COO 


01  •— I  CO  r— I 

CO  03     CO  CO 
p  cso  ip 

4t<  LO  lio 


O  CO  CD  03 
O  C4  10  CO  CO 

oa  CO  TtH  cj  o 


CO  CI  CO  CO  uo 

CD  r—  O  CO 
1^  -*  LO  C3  01 


^  t)<  01  CO  CO 
LO  1—  C32  ■1<  CO 

cm  o  CO  o  o 


C5  «  O  10 
00  — '  ^  -^fl 

O  CI  -t<  o 


^  00  cj 

.-H        CO  L-^  O 

CO  1^  o  CO  CI 


CD  lO  CI  -H 
t--  O  05  o 

CO  OS  in 


loioioiolo     -^in-t*^^     TtiTj'-ttTi*^     10 10 10 10  LO     "cH-^Tti^co  co-*ioco 


i-^  CI  t~  o 
CO  10  CO  O  CO 
CO  O  O  03 


r-  00     CO  CD 

C^  CO  LO  LO  Tj< 
O  CO  CO  CO  10 


— I  ^  CO  CO 

CO  LO  -H  10  CO 
CO  CO  O  CO 


00  O  O  CO  00 
O  CO  03  l-^ 
O  CI  -1<  O  CD 


OC  1^  CO  LO 
00  CO  OJ  CO 
03        03  01 


CO  |-~  CO  O  CO 

CO  o:  01  lO  CI 

LO   CO  — <  — 


LO  01  O  — 
01  'J'     CO  CD 

O  00  CD  CO  1— I 


Tt<  10  LO  -t< 


10  -(>  O  LO  -* 


LO  LO  -)H  LO  -)<  LO  -f  LO  LO 


■*^-*-*C0  COt)<iOCOO 


lo  m  o  1^  ^ 
CO  Tt<     01  CI 

C4         LO  CI  r— I 


03  CO  ^  LO  o 
10  O  '-I  CO 
CO  liO       CD  CI 


— '  CO  ^  00  CO 

LO  CO  cv  CO  10 
^  o  ■*  ^ 


o  CO     01  00 

10  ^  Tt<  "O 

CI  o 


CD  r-^  C3  CO 
r-H  CO  -h  CD  10 

--I       CO  o 


CO  CO  O  LO 
O  CO  CI  o 
OJ  CO  CO  10 


LO  CD  CI  lO 
00  LO  03 

o  01 01 


(--(      rtOOIr^O      COrHOOO  OCI00005 


^      O  — I  ^ 


00  05     !>•  in 


00  00  CO  CO  o 

Tt(  O  C3 
CO  00  CI  CO  Tt> 


01  — '  O  ^ 

O  01  CO  03  O 

CO  CO  03  00 


t—        ^  LO 
00  X  LO  CO  CO 

CO  in  01  ^  "O 


o  CO  CI  ^  CO 
^  f  o 

CI       CO  CO  G3 


O  CI  O  CO  CO 

CO  05  C73  Tti 
10     CO  CO 


Ttf  CI 

to  00  o 
^  00  CO  LO  CD 


CI  n-l 

CI  Tjf  t— 

^  CO  01  ^ 


CO     m  m  m     lo  lo  m  lo        lo  m  ^t*  lo  rt<     m  co     m        10  m  lo  lo  m        tj-  ; 


-h  -*i  Tfi 

00  CO  CO  —I  CO 
LO  CO  01  03  CO 


01       Tt<  CD 

m  CO  in  CI  1^ 

1—  — I  CO  t1( 


Tt<  CI  O  CO  CD 
CO  CO  't^  O  CO 
CO  LO  CO  CO  GO 


O  CO  10  LO 

Tt<  05 o  in 
O  00  CO  oo 


00  TjH  -H  CO  CO 
CO        in  CI 
in  03  CI  O  CD 


LO  C5  C3  C)  00 

o  01  c;  CI  1.0 

O  C3  C3  C3  GO 


Tt<  in  o  ^ 

01  -*  00  CI 
— '  CO  Tt<  — I 


CO     CO  10  in     in  in  CD  *o  ^ 


T)<  in  m 


CI   -f  LO  r-l  CO 

I  -     ^  -(<  00 

<p  p  01  p 

m  t-  o  o  C5 


in  CO  CO  o  CO 
i-^  o  in  CO  03 

C3  r-l  —  t-~ 


03  — '  01 

o  C3  in  — < 

CO  ^  -t<  C?3  CO 


01  CO  CO  o  o 
o     oi  CO  03 

^  CO  CO  CO  CO 


10  LO  LO  CO  LO 

I — ^  GO  CO  CI  CO 

0  -Ch  'O  C3  03 

01  m  CO  03  CD 


CO  CC  01 


o  CI  LO  c»  01 

00  CD  in  t--  CD 
05  00  03  O  CO 


<OCO        CZ)OL-^C^03        030L-^03C^  03000003) 


l-^  -f  03  O 

CO  C3  —  o 

p  T"!  ip  p 
~  CI 


CD  03  in  o  C3 

CD  O  CI  CO  -t^ 

oD  00  CO  o 


—  LO  oo  CO  CD 
CO  C3  C3  CI 
LO  O  L^ 


O  -t<  CO  CO  CI 

Tt<  O  O  CO  --I 
^  01        CO  03 


-*  Tt(  03  01 

CO  00  o  o  01 
in  in     CO  03 


01  00  CO  10  C3 
01  CO        CO  03 
01  CO  CD 


I-  CO  — ' 

01 1—  CI  CO 
03  05  CO  m  LO 


-H  CO  CI  CD 

o:  CO  C3  r-H 

i-H  O  03 


01  CO     LO  uo     LO     m  LO  CO        LO  CO  ^ 


LO  CO  Tt<  CO  .      10  'cH  in  -*     CI  CO  CI  01        01  m  LO  . 


o  in  o  in 
o  CO  c^i  o  CO 
o  in  03  C3 


TtH       O  CI  o 

CD  O  CO  CD 

o  CI  in  o  o 


C3  O  00  lO  o 
CO  03  00  o  o 
CI  cr3 CI  1^ 


in  -*  CI  ^ 

CD  03  01  CD 

LO  O  CO  C3 


C3  O  O 

CD  in  in  03 
CI  in  CO  CO 


CO     <  03  1^-  ^ 

o  in 

O  03  O  LO 


CO  -H  Tf( 

CD  CI  <» 

Tf(  0  m  ^ 


CI  ■*  Ln  -H  -* 


in  in  in  in  co 


-t^  LO  in 


CO  CO  CO  CJ  ' 


— I  O  O  -*  C5 
0  — I  C»  Tj(  05 
-*  t~-  03  CO  00 


LO  CI     01  CO 
o  CI  CO  in 
o  -f<  -*<  01 


CO  CO  CO  GO  CO 
CD  01  CD  CO 
CO  O  CI  03 


01  Tt>  O  CO 
CO  GO  I-^  CD 
CO  03  O  05  01 


O  CI  CI  GO 
03)  r-H  CO  LO  03 
CO  O        0"l  00 


01  m  o  CO 
03  o  i  n  o  CO 

CD        CO  ^  C3 


—  CO  — <  00 

-f  T*f  LO 
CO  -p  CO  m 


1-1  01  CO  01  ci     CO  CI  CO  CO  —< 


I  CI  CO     ci  01  CI  01  CI     CI  CO  CI  CO  CI 


—<  CO  CO  o 


03  CO  ^  O 

CO  01  10  CO 
t~  CO  00 


^  O  — I  O  ^ 

<j3 1^  in  -t( 
Tt<  01  CO  CO  CO 


01  in  Tji  CO 

03  I  -  CO  03 

CI  CO  CD  ^  in 


01  CO  i-^  10  ic 
CI  C3  ^  C3  f-l 

CO  Tt<  o  — . 


GO  CO  1-^  01  CO 

LO     CO  m  LO 

CI  -h  CO  O  CO 


1-1  CO  CO  O  01 
CO  l~  CO  03  03 
C35  ^  -fl 


CO  CD  TjH  03 

C3  in  1^  00 
CO     in  01 


0—000     O— — O 


CI     C3  ^  in 

GO  CD  10  03  — 
p  CO  —  CO  Tt< 

cb  —  01  —  — 


—  01  O  CI  -*l 

00  CO  m  00  — ' 
in  —     10  C3 


i-^  GO  C3  —  o 
C33  CI  CO  CO  TtH 

o  CD  in  -p  in 


O  — I  O  LO  CO 

r-H  c/D  in 
CO  rt<  o  -t<  —I 


CI  CO  LO  o>  o 

CO        03  03  -fH 
i  n  CO  LO  LO 


I— I  01  CO  CO  in 
CO  CO  01  — 

1^  03  CO  CO 


GO  O  I  -  03 
CO  CD  CD 
CO  CO  Ol 


000c  o     o  —  -<o 


•saj'Bnia^ 


o  —    01  03 

CI  -)<  -H  — 

— I  —  o  03  m 


CO  o  1^  ID  03 

03  Cl  CC  00  CD 
C3  CO  03  C3  CI 


CO  —  CO  in  o 

I—  O  01  CO  o 
GO  O  —  CO  O 


CO  CO  CI  CO  CO 
—  — c  —  — 1  03 

o  in  o 


cm  CO  m  03  c  I 

C30  CO  r-H  CO  GO 

o  CO  -H  00 


LO  1^  O  CO 
l-^  Tf<  LO  — 
00  O  CO  —  OD 


O  Tj* 
CI  CO  CO  ^  O 
CO  00  —  00 


•sai^K 


O  03  CO  CO  — 

00  CI  m  00  CO 

00  CO  o>  O  M< 


r~  o  CO  Tt*  — ' 

O  CO  CO  —  CO 
O  CO  O  O 


03  cj  in  o 

CI  C3  CO  o 
—  C3  CO  CO  O 


1^       00  CI 

GO  C30  00  00  O 

03  -ti  10  03  in 


01 in  —  00 

— 1  O  CO  —  — 
OJ  03  CD  CO  — 


m  CO  o  CO 
CI  in  m  m  oo 

—  O  CO  r-1 


CO  O  CC  CO  CO 

CO  m  03 

CO  -H  00  CI  — 


m 
H 

o 

EH 

c/3 


<A 

< 

1—1 

< 


on 

■VI 

o 
o 

< 


Q   :C2H  : 


Qiz;Q  , 

iJKWoaH 


< 
or 


03  Q 


.  .«  .  . 

:   :0  :  : 

.  .Q  .  . 

:  ,:5z;  : 
< 

:    :Q  :  : 

■  ■  • 
<! 

;^oW!z;i-< 


>— I 

:> 

o 
o 


Q 


<: 

Gf  .<! 
CO  : 

<j&oeuO 


:    :    ;2  : 
■       O  ■ 
H 

:    :0§  : 
-  .^tH 
<'^< 
■QMj  • 
:  I— <  W^j 

<=Opq 

•0<j3tS  ■ 

^  - 
coco 
•  QQQ  . 

coOhJ 
OZiJ^Jj 


1-1 

:  :W  :  : 
•  -iz;  ■  • 

<; 

;  ;m  ;  : 

Q 

WSSSco 


^  bo's  'So 
.15  -S  -5  -5 


i-icicotC     incor^ooci     o^cicoth  incci^oooi 


49 


— ;  ^  (M  JO 


lO  o     00  05     o  — I  '^^  CO  'J' 


o  OD  o 


o 


p 
o 


03  ^  CD 
.  O  -f 

:  p  o  p 
bob 


:  p 
b 


C5  so  CO  CO 

o  o  o  — . 
o  p  O  p  p 

o     c>  o  i> 


p 
b 


:  p 
b 


lO  ^ 
.  o  :o 
:  p  — 

b  b 


O        CC  CO 

•  o  -  OJ 
o   :  o    :  o 


CD  50  CO  lO 

o  o  o  o  o 
9"  P  ?  9"  P 
b  o  b  b  b 


:  p 
b 


CD  CO 
■  O  ^ 

:  o  o  o 


CO 
.  o  o 
:  ~  o 


in  —I 
■  o  CO 

;  P 

b  b 


o 


a 

M 

J) 
a 

'A 

CO 


'J' 


in 


'J' 


CO 


CO 


ira  CO  — '  CO 
lo 

o  C3  c-l  -ti 


Ci  c»  — '  CO  X) 
CO  01  CI 
C3  lO  Ol  o 


C-1  CD  C3  —  era 
^  CO  o  cc  o 
— '  O  -1" 


CO        CO  CD  CD 
00  I-  CO  01 
03  01  1^  O  '-I 


CO  C3  — '  O  O 
01  CD  CD  Tt< 
O  lO  -*l  — ■  "O 


^  — I  CO  lO  00 
Ol  -H  O'  lO  ^ 
a:  O  CO  Ol  CO 


•-^  lO  iC 
C3  IQ        Cl  Ol 

m  C5 1--  o 


c-i  Ol  o»  CO        CO  CO  CO  ci  Ol     Ol  01  CO  01  CO     oi  oi  oi  oi  oi     CO  -*  ira  TjH  lo 


CO  r-l  —  C5  o 


r-  01  CO  o 

-H  00  CO  o 
iO  00  — I 


CO  C3 o 
Ol  o  CO  00  ira 
CD  00  lO  o  Ol 


O  — I  -t<  -+(  o 
1^  O  C3  Ol  01 
C5  O  »  CO  CD 


O  O  -f  02 
CO  1  -  CO  C2  t» 
C5  •*  CO  -t<  GO 


CD  T(<  lOi  CD 
— I  lO  C5  '-H  CO 
CD  CO  CO  01  CD 


CO  CD  ^  CD 
■*  O  l-^  O  03 
CO  lO  -f  ^  UO 


03  lO  CD  OD 
-tl  OO  CD 
^  — I  O  CO 


Cl  -H  -H  Ol  ^ 


00  CO  GO  CD 

CO  ^  o  CO  »  o 
1(0  — '  00  —  o 


Ol  Ol  CO  Ol  CO 


-.O  — I  OJ  i-H  00 
03  CO  00  ^  Ol 

O  —  o;  GO 


01  lo  "O  r—  cs 

C~  GO  ^  lO  00 
— '  O  lO  O 


CO  O  t—  Ol 
irj  O  CD  Ol  CC 
O  CO  CO  O  Ol 


C4  LO  CD  0>  CD 

^  —   1<  O 

Ci  O  O  O  C5 


lO  CI  ^  01 

o  CO  o  01 

lO  lO  00 


Ol  O  —  lO 
t--  CO  Ol 
CD  i.O 


^  _  O  -H  -< 


— I  — I  O  ^ 


O  ^ 


o  o  ^  o  o 


— I  ^      01  — I 


O  O  lO  o 


•sal's  ui3£ 


02  CO  lO  -H  02 
CO  O  l  Ol  02 

CD  m  Ol  o 


CO  -h  01  -tl  C3 
l-^  O  CD  03 
CD  O)  CO  CO  C3 


lO  O  1^  CD 
00  CO  C5  CO  oo 
•-H  CD  CO  CO  CO 


«  Ol  C3  — I  00 
CO       CD  ^  O 
CO  Ol  Ol  Ol 


00  Ol  lO  rfH  10) 
CO  01  00  CO 
CO  CO  lO  Ol  LO 


CO  -tl  O  — I  ^ 

CO  00  o  t-^  o 

Tti  lO  lO  CD  OI 


GO  CO  -H  CO  o 
CO  o  ^  C5  c: 
00  'JO  '-^  IZ)  r-i 


COlOTi^iOiO      TjH-*-*OLO      C010CD1O-*      lOTfCOiraCD      lOTt<iO-f-*      COlOCOCDt^  lOC0-*aj-* 


^  05  Ol  CO  05 
02  CO  Ol  C2  Ol 

r-  03  O 


00     CO  — I  lo 

O  00  Ol  CO 

CD  lO  Tt(  rH  lO 


CO  C5  05  CI 
CO  lO  -H  CO  00 
rj<        01  CO  CO 


CO  Tt<  CD  O  —I 
LO  00  05 
O  CO  T  CO 


CO  ^  Ol  CO  Ol 

^0  05  1^03 
O  CD  G5  — I 


O  Ol  "O  OS  T*H 

lO  CD  CO  O 
CO  1^  CO 


Ol  ira 
CO  CO  lo 

O  O  Oi  1-^ 


CO  Ol  Ol  CO  Ol      Ol  Ol  CI  CO  CO      CO  CO  CO  CO  Ol       Ol  01  CO  01  CO      CO  Ol  01  CI  Ol      CO  CO  CO  CO  -* 


00  Tt(  CO  CO  o 
CO  O  03  Ol 
02  CO        r-<  CO 


CO  CO  05  CO 
CD  Ol  CO  CD  00 
O  Ol  03  --H 


05     CO  i  ra  T)H 

I— I  !>.  »o  Ol  O 

1-^  -t<  — ( ira  CI 


00  CO  CO  ^  t- 

LO  Ol  — '  CO 
— I  Ol  CO  -r  00 


Id   r—  CO  CO 

lO  01  O  ^  lO 

CO  o  ira  o 


00  Ol  O  Ol  o 

GO  Ol  -O:  CD  CO 
CO  Ol  1-^  CO  -t< 


-H  ^        00  O 

CO  CO  Oi 
I- 1  ~  — ,  ~  — < 


Ol  Ol  01  01  01      CI  Ol  —  01  01      Ol  01  CO  01  01      CI  01  01  01  01       01  01  01  01  CI 


01  Ol  Ol  CO  01      01  — I  01 


•ITJ^OX 


CO  CO  CD  1^  CO 

LO  o  o  ira 
05  — <  lO 


GO  CO  Tt<  1^  00 
O  lO  01  -(< 
GO  O  CO 


CO  CO  Ol  in 

O  01  01  GO  00 

00  1^     CO  Ol 


Ol  O  CO  1^ 
«  r~  01  'i*  00 
CO  Ol  -f 


m  CO  03  o  o 

O  lO  05  05 
CO        CD  CO  05 


CX)  CO  CD  CD 
00  -H  CD  UO  O 
O  CO  ^  t- 


lo  oo  o  CO  m 

CO  03  00  Ol  C2 

^  ic  CO 


050505  00  00        l^Olt^OOO        C00005000        00O0C3COO5        C5  I  -  CO  1  -  1^       OOOOOO  OOt^t^COO 


"O  1^  Ol  CD 
Ol  00  CO  CO  "O 
LO  CD  05  Ol 


— I  LO  CO  CD 
t-^  Tt<  — I  -h  CO 
05  1-^  00  LO  -*< 


C5  in  Ol  CO  Ol 

00  CO  1-^  01  CO 
LO  CD  00  CO 


— 1  GO  — I  r-^  00 

00  05  o 
in  ^     CO  00 


Ol  in     LO  Ol 

CI  O  — I  LO 
r)(       -f  CI 


O  ^       00  CO 

CO  CO  in  CO 
t~  Ol  CO  CO 


m  —  Ol  ^  ^ 

—  C»  O  05  CO 
CO  CO  CD  1^  O 


m^co-Hrf     coTt<co-*in     '*-*-*'Tt<Tf     -*-i<inTH-*     -#-ji-Hcort<     LOTfiLomco  locococio 


GO  CO  O  Ol 
Tt(  CD  CD  O 
-5>  -f  ^  01  -* 


!>•  CO  CO  — H 

CO  o  in  GO 

00  CO  LO  ^ 


Tt<  — I  o  in  CO 
05  in  'n  o 
CO     o  in  05 


— <  CD  05 

-c  o;  CO  m  i-^ 

O  O  01  CO  CO 


CO  17:3  in  o  00 

00  CD  —  CO 
CO        01  — 


05  GO  O 

m  CO  c»  03 
CO  o     1^  Ol 


O       00  01 

m  I — ^  Ol  CO  — * 
m  05  05  CO 


■*-t<in-*-*<  co-^cO'*-* 


in  lo  CO 


'f  -f  -t  -t< 


Tt<  CO        -t<  CO 


-*     ^  ^ 


CO  CO  CO  o  o 


"sal's  uia^q^ 


•sai^nj 


IT-  CO  Ol  C5  00 

0  CO     CO  05 

01  -H  O 


CO  CD  O  Ol 

-t<    O   00  ^ 

Ol  --I  in  CO 


—  CO  Ol  in 
Tt<  Ln  -f  1^  o 

-t<  00  CO  01  05 


O  05  01  05 
O  Ol  Ol  00 

in  in  <z>  — <  CO 


01  Ol  — I  o<  01       Ol  CO  — I  01  vo      CO  Ol  CO  CO  Ol      Ol  Ol  Ol  Ol 


I  ^  05  in  Tt< 

oo  in     05  -^^ 

CO  00  CO  CD  05 

dl  ^  CI  r-H 


0  C5  O  -H  ^ 
C5  ^  CD  CO  CD 

CO  CD  in  p 

01  CO  rh  M 


CD  Tt<  Tti  in  m 

GO  O  03  CO  05 
Ol       05  p 

CO  Ol     CO  00 


01  'SI  CO  CD  CO 
CO  CD  Ol  Ol  L' 

CO  I— I     in  CO 


05  Ol  in  CO  in 
CD  •— I  in  in  05 
Ol  in  05  1^ 


o  in  CO  CO  ^ 

CO  CO  O  1^  o 


CO  O  CO  CD  00 
05  03  GO  00  Ol 
■iH  Ol  C5  CO  o 


CDCOLOCOin        CD  CD  in  CO  COCOCOCOCO  COCDCDincD 


CD  CO  Ol  —1  CI 
CO  CD  O  05 
—  p  Ol  CD 

CO  CO  CD  in  CO 


00  05  CD 
O  LO  1^  CO  05 

CO  in  CO  CO  05 

l-^  00  CD  00 


00  CI  ^  r-l 

Tt<  in  •*  ^  CO 
p     p  1^  p 

00  b  in  CO  b 


in  05  CO  CO  >n 
l:^  Ol 

in  o  t-  05  Ol 


00  — I  t- 

1-^  05  CO  LO 
05  in  CO  CD 


Ol  CD  CD  CO  'Ch 
CO  05  00  CO  Ol 

— 1 m  00 


^  CD  CD  r-H 

o  CO  -cH  in  CO 
o  Ol  00  Ol  CO 


r-i  00  r — Ol 

^  — '  05  LO 

Ol  CO  -t  o 


CD  ^  —I  00 

00  CO  00  CO  CO 

Ln  o 


00  Ol  CO 

CO  in  in  Ol  ^ 

Ln  o  oo  CO 


in  CO  in  in  CO 


in  CO  in  LO  CD 


l  ^  CO  1-  CD  -D" 


CD  LO  CD  CD  LO       LO  CO  CO  -H  -H       -*  CD  in  CO  CO 


o 

o 

CO 

C5 

o 

01 

05 

CO 

CO 

o 

o 

CO 

CO 

o 

CD 

01 

CO 

o 

CO 

o 

OI 

05 

CO 

CO 

1^ 

CD 

CNl 

o 

~t 

CO 

05 

CD 

CO 

in 

CI 

o 

CO 

-h 

CO 

Ol 

CO 

C5 

CO 

00 

Ol 

CD 

00 

-* 

CD 

CD 

O 

•I'B^OX 

p 

p 

CO 

CO 

p 

CI 

Ol 

1^ 

Ol 

GO 

CI 

CI 

p 

in 

CI 

CO 

in 

CO 

in 

L^ 

p 

05 

lb 

b 

00 

CD 

in 

in 

b 

in 

CO 

in 

b 

L- 

b 

00 

b 

I  - 

in 

b 

<)0 

CO 

b 

b 

b 

CO 

b 

I'n 

00 

I- 

Ol 

Ol 

CO 

i-H 

r-( 

CO 

05 

05 

CO 

Ol 

CD 

05 

CD 

~i> 

m 

in 

00 

o 

05 

CO 

00 

05 

o 

CO 

CD 

CO 

CO 

O 

CO 

CO 

(X> 

lO 

00 

Ol 

o< 

Ol 

00 

o 

in 

Ol 

o 

m 

O 

in 

Ol 

LO 

CO 

o 

o 

CO 

00 

05 

x> 

C5 

in 

00 

05 

01 

CO 

CD 

O 

CO 

•sal's  uia^ 

Ol 

in 

01 

CO 

CI 

05 

CO 

00 

Ol 

03 

CO 

o 

CD 

in 

CD 

CO 

1^ 

o 

CO 

-f 

CO 

in 

05 

GO 

05 

00 

CO 

00 

00 

05 

00 

CO 

00 

1^ 

03 

C5 

o 

00 

t-- 

CO 

1^ 

C5 

o 

o 

00 

C5 

1  ~ 

CD 

o 

GO 

OS 

t- 

00 

in 

CO 

in 

CO 

CO 

CO 

LO 

00 

05 

CO 

CD 

CO 

1— 

00 

CI 

in 

CD 

CD 

CO 

CO 

CO 

00 

CD 

in 

CO 

in 

CO 

1-1 

1- 

o 

Ol 

00 

Ol 

CO 

LO 

CD 

CD 

LO 

1^ 

CD 

CO 

CD 

CO 

CO 

CO 

CO 

CO 

05 

CO 

GO 

01 

o 

o 

O 

CO 

•sai^i^ 

Ol 

o 

in 

(Z) 

p 

CO 

CO 

-* 

o 

00 

o 

05 

CO 

-t 

o 

05 

00 

CO 

in 

C5 

CO 

m 

C5 

C5 

CO 

CO 

CO 

05 

m 

to 

CO 

b 

C5 

00 

00 

00 

05 

I- 

00 

1^ 

o 

00 

00 

00 

CO 

00 

CO 

CO 

CO 

05 

CD 

LO 

CO 

in 

05 

CO 

CD 

00 

00 

CO 

H 
O 

h-c 

H 


EH 

I— I 


H 
CO 

W  ■ 

■ 

CO 

■  W  . 
:cO  : 

O 

>-] 

O 

■Q  ■ 
<1 


O  ■< 

►JX!o!=<H 
B3  'a)  a,  S  CO 


HO 

^^^^ 
>-ic»2 

in  CO  i-^  00  05 


< 

Of 

CO 

W 


CO 
:« 

Q 


tOOMMPQ 


o 

.   .33   .  . 

:    :0   :  : 

>H 

.  .Q  .  . 
:    :i2;   :  : 

<5 

CO 

:    :Q   :  : 

■  ■  ■ 
<3 

■  -K 


:   :  : 

:  :  :>  : 
•    ■    ■«  • 

,&r3   :  : 

<tJ&OpMO 
>-lSOcoO 


:   :  : 

o  • 

H 

;  ;o§  ; 

coco 
QQQ  . 

Sqcoco*!; 

co^qOM 
coOh4i-J  J 
OISh-JiJ  J 
pC|<|OOj-J 


>-) 

:  :W  :  : 
•    -a   •  ■ 

Q 

;<co'  ; 

H-S'^co'— ' 


in  CO  l-^  GO  05 


50 


•sasnojj 


m  rS>        Vj  o 


O  — I  C-l  CO 


lO  to        CO  03 


O  ^  <M  ~  CO 
f^T  't^l  r^T  °c3  ^-j 


O  «0  I—  00 

CI  CI  T^i  ^1 


OS  O  r— I 

CO  CO 


-H 

,  1 

O  t- 

1^ 

CO 

CD 

I— 

CD 

CO 

CD 

CO 

03 

03 

CI 

CO 

CD 

CD 

CO 

CO 

lO 

-H 

CO 

00 

CI 

lO 

XJ 

CO 

o 

o 

CO 

CO 

o 

CO 

1 — I 

o 

lO 

CI 

CD 

o 

03 

CO 

c— 

03 

CO 

CO 

m 

C73 

o 

in 

CI 

'  1 

1 — 1 

1~ 

CD 

CO 

CO 

-1 

CI 

CO 

CD 

t~ 

CO 

cq 

00 

CD 

CD 

C3 

CO 

lO 

t~ 

o 

CO 

o 

03 

CO 

lO 

03 

o 

lO 

CI 

CI 

CI 

00 

CO 

CI 

o 

lO 

CO 

r~ 

o 

o 

O  CO 

CD 

00 

o 

<M 

CD 

o 

t~ 

CO 

CO 

03 

CO 

JO 

lO 

in 

CI 

CO 

CO 

1 — 1 

CO 

CO 

O 

CO 

a> 

00 

iC 

o 

CO  CD 

CI 

03 

o 

CO 

03 

(M' 

co" 

CD~ 

I 

O 

c  r 

co" 

■J3" 

cd" 

co" 

cf 

cf 

CO 

'O" 

-+" 

cf 

co' 

co" 

co" 

co" 

go" 

co" 

C  1 

CO 

CI 

1 — 1 

CI 

CI 

' — ' 

■ — < 

1—1 

<M 

CD 

CO 

CO 

t— 

O 

CD 

o 

o 

CD 

o 

t- 

o 

CO 

CI 

03 

cn 

t~ 

-+ 

CO 

o 

CO 

<M 

CI 

o 

<M 

CO 

03 

CD 

I— 

CO 

CD 

cc 

CI 

t— 

CO 

T  1 

CO 

CI 

05 

CI 

CO 

CO 

CO 

CO 

CD 

o 

c^ 

CO 

00 

CTS  O 

o 

CD 

CO 

CO 

lO 

t— 

lO 

■CD 

o 

CO 

CI 

o 

1 — 1 

CD 

00  t- 

in 

o_ 

CO 

CI 

OO" 

lO' 

co" 

lO" 

lO 

id 

J- 

-h" 

o 

<m" 

co' 

co" 

oT 

1^ 

o" 

OO" 

go" 

CD 

Cl" 

lO" 

co" 

-+" 

CI 

lO 

yj" 

co~ 

o" 

O'l 

(M 

CD 

on 

CD 

I — 1 

CO 

CI 

CO 

cq 

CO 

CI 

o 

CO 

o 

03 

lO 

CJ3 

CO 

OT 

1 — t 

CO 

CO 

CO 

CO 

CI 

CT 

in 

CI 

CO 

-* 

03 

h~ 

o 

CO 

CD 

CI 

CO 

in 

o 

CO 

CO 

in 

i~ 

'Q 

J— 1 

CO 

CO 

00 

CO 

CO 

CO 

CD 

1>-  00 

o 

03 

CO 

CO 

CO 

I — 1 

OS 

CM 

t~ 

CD 

-* 

CD 

t— 

00 

0O__ 

C5 

03 

CI 

CO 

05 

t- 

03 

CI 

1 — 1 

03 

icT 

co" 

Cd" 

1 — 1 

co" 

cd" 

■^" 

co" 

cd" 

id 

co" 

lO" 

cf 

-*" 

co" 

cf 

co" 

1 — 1 

T— I 

en 

(M 

o 

(M 

03 

O  t~  CO 

CO 

00 

CI 

CI 

t~ 

-H 

CT 

GO 

1^ 

CD 

03 

CD 

CI 

C3 

03 

00 

CD 

1^ 

OS 

00 

-* 

CO 

1 — 1 

CO 

^ 

00 

00 

CD 

o 

CI 

t~ 

o 

CO 

CT 

-* 

03 

CI 

CO 

CO 

00 

CM 

CO 

lO 

CO 

CI 

I— f 

03 

o 

CO 

CO 

CO 

lO 

■■£> 

CD 

CI 

CD 

00 

co" 

co" 

co' 

t-" 

co" 

!  1 

cf 

iC 

co" 

-*" 

cd" 

in" 

co" 

O  lO 

00 

CO 

O 

CD 

CO 

OC 

CD 

o 

CO 

o 

03 

CO 

03 

o 

CO 

o 

in 

CD 

in 

O  CO 

in 

O 

CI 

03 

1 — 1 

lO 

CO 

CO 

CO 

■CO 

lO 

1 — 1 

CO 

CI 

CO 

o 

CI 

CO 

CD 

CO 

CO 

CO 

in  £-  -th 

CO 

lO 

1 — 1 

CO 

CI 

CO 

CI 

-V 

03 

CT 

CO 

CD 

r— < 

t> 
oq 


■araoo'jj 


3  a 

CO 


a 

H 

lO  H 

H  CM 


I— (  ^ 


I— I 


CO 

•O 
T-T 

o 


•"it 
O 

ui 
in 


03 
CO 
(M 


CO 

cq 


1-  CO  in  -H  CI 

■  Cl         O  i—l  CI 

r— '  T— I  in  J:^ 


CO  m  CO 
I— I  o  i~  CO  m 

Cl  ^  CI  ^ 


O  03        CD  00 

CI  o  vj  i~ 
^      ^  cq  CO 


CO  CO  1 — ^  o  in 

r-H  CO  -*  CD  o 

CO      in  CO  t~ 


CD  o  CO  in  o 

K  ~Tti  ^  ^ 

CD  CI      in  CO 

cq"  cf 


00  O  >— I  o 

C3  cq  03  CO 

eft  in  in  CO  r— I 

rt'co  CO  '-'" 


■— I  03  cq 

O  — ■  00 

in  03  03 


oq 

00 


o 


CO  in     CO  03 

CI  ,— I  t-  03 
03  ^ 


03  CO  O  CO  o 

GO  CO  c:  -tH  00 
oi  cq 


J:~  in  I— I  O  t~ 
in  CD  i^  ^  m 


I  r-H  in  CD 
m  CO  00  o  o3 
in      CD  ci  03 


ci  in      cq  cq 

O  CD  O  GO  CI 

. — ^  CO    I  in 


t-'      CD  cq 
^  GO  CI  in  CO 

^         CO  CI 


-H  O  O 
O  .-^  t- 

r-H 


CO 

CO 
Oi 


CI  o  CO  O 

CO-  O  C73  '-H  o 
1^  CO  -r|H  00  CO 


CO  O  ^ 
CO  O  I— I  CO 
^  O  '^l  CT  r— I 


i-H  03  00  cq  CO 
00  CO  in  t— 
C73  CO  -H^  m 


CO  ^  00  in  O 

lO  CO  I—  CO 
CI  00  03  03 


-rtl  Oi  1^  00 
lO  03  CD  O  CO 
r/j  l~  CD  1— '  00 


CI  03  -fl  ^  ^ 

00  cq  CT  CI  j:- 
o  CO  Oi  1 — ^  o 


CD  CO  1— I 
CI  — '  Oi 
CD  CO  00 


m  I— 1 CO  CI 


r— I  cq  CO  CD  CO 


in 


s 


in  in  I-H  Oi  00 
o  in  CO  03 1~ 
in  Oi  ci 


c  CD  ^  cq  CO 

£^  CD  ^  in  r-H 

^  r-<  CI  in  CI 


^  CO  cq  1- 
in  1—  GO  i- 


03  ~  ^  in  CO 
CO  03  CD  cq  Oi 
00  cq  in  ^  ^ 


o  in  03 CD 
1— I  CO  CO  CO  cq 
CO  c-q  in  03  CO 


cq  CO      00  CO 
in  -co  as  cq  CD 
o  ^  cq 


CD  Oi  CO 
03  CD 
—  CD 


in 
in 
o 


m  cq  ci  Oi  ci 
o  CO  oj  CD  in 
00  CD  cq 

icT  c/i"  co~  -tiT  of 


CO  CO  CO  in  in 

CO  Oi  03 

00  cj  o  C73  cq 

cfj  cf  crT  in"  ^ 
CO      -ti  ^ 


CD  IQ  CO  03  I— I 

00  CT  cq  CO 
in  CD  -t-  ^  t~ 


1^  r-  CO  CO 

Oi  cq  o  CI  00 

CD  Cl  Oi  CO  -rf 

cf  o"  o"  ^"  co" 

CO  I — ^  I — I  I — ^  I — I 


CO  -t<  in  -+  CO 

CD  CD  iC 

in  ^-cD  cq  Oi 
^"  cT  in"  cf  o" 

Cl  r— I 


CO  CD'  CO  O  CO 
Oi  03  Cl  in  CD 
00  03  CD  in  'i— I 


00  CD  CO 
CO  ^  GO 
CO  CO  OS 


CO 
00 
CO 


Oi  CO  00  ^ 

t~  00  o  03  in 
cq  00  t~  00  03 


CO      cq  Cl  — 

I  CO  — '  o 

O      CD  7— I  cq 


O  Oi  CO  CD  O 

CO  ^  in  cq 

CO  CO  r— I  ^  CO 


in  t-~  ■— I  Oi  00 

0  Oi  Oi  00  in 

01  Oi  CO'  GO  00 

co"— '"cf  cq  cq" 


cq  cq  o  cq  CO 

Oi  i-H  CO  o 

00  I — ^  1—1  CO  in 


03  CO  O  t~ 

Cl  Cl  in  o  CO 
cq  Cl  —  1— I 


CD  CO  CO 
CO  Cl  t~ 
1— I  00  Cl 


00 

o 


cD  -*  Oi  03  cq 

Cl  t~  ^-^  ^ 
00  ^  O  00  CO 


1— I  Cl  CO  CD  cq 

£~  CO  Cl  o  -* 

CO  ^  Oi  in 
— h"  r— "  in"  t-^ 


CO  O  O  03  CD 
Cl  03  Cl  O  CO 

CO      Cl  -*  i~ 


Oi  m  03  CO 

—  Oi  t—  cq 

CO   I-  1— I  C73 

ccT  — -~  in"  co' 


Cl  — I  o  in  o 
CO  00  t~  in  CO 
CO  in  X  Cl  — . 

"  cd"  i-T 


r—  Cl  in  GO  J:~ 

O  CO  CD  J;^  1—1 


OD  t- 
— ^  CD  t~ 
:^  in 


CO 


o 


o 


tZ2 

o 

1—1 


I— ( 


CO  o  Cl  in  1— I 
1— I  ^  CO  cr3  OO 
CO      CO  in 


Oi  in  cq  CO  cq 
in  Cl  in  -^+1 
CO      t~  in  1 — I 


CO  CO  ^  in  £~ 

l~  Oi  t~  CO  CO 


in  CO  Cl  o  Oi 
^  i-  Oi  in 

Cl        CO  CO  Cl 


t~  O  Oi  CD 
CO        00  O  CD 

cq  lo  Oi  CO 


CD      00  cq  cc 

CO  Cl  Cl  Cl 


t-  O  Oi 
^  cO 
O  1>- 


Oi 

o 
t> 

I  CO 


o 

Eh 

;  ;  ;  .  :    ;    :  •  :    ;  :  :  :  :    :  :  :  ;  :    ;  ;  ;  :  ;    i  ;g§  :    ;  :  ; 

ph"  -  -  .-en: 

:::^:     Sm<=>::        :::::       ::©::  -agj:  ::- 

gl^lg 

«|?^o  |§i|i  ii§^l  ii^ll  ^§§§1  |g§ 

^ggg'^  ^s"ls  i^^li  gggs^  gg^^dd  g|i 

"JS^IoSeh  wgrt-ijO  EHtjEHtfPS  SoMisa  <tjt>0(l<0  tf<|OOH  H20 
MmphWos     mWOmS      wooapqpq     ^oM<!M      jWttccO     ojfMfcW  WSfe 


<! 
Q 

P 
O 

Oi 


O 

H 


— jr-HClCO^        mcot>.00O3  Oi— ICICO^        mcDt^GOOi  Or— 'Cl     ICO        ^mCDt-~CO  OjO-— 1 

pq  ^  ,_i  ^  ^  ^      ^  ^      ^  r-H      cq  Cl  Cl    I  Cl      Cl  cq  Cl  Cl  Cl      cq  co  co 


51 


r— I  r-H  (^"1  CC 


O  CO  t—  »  C5 


 d      .  ....... 

OCOt^X'Ol  O^Ol'^CO  -^llOCOt-OO 
^  ^  ^  ^  r-l      -M  ^1  T-VrS  fM     C-^        iM  fM  fM 


as  o  r-H 

CO  TO 


<5 


^  -tH  ^  (35 
QO  -H  1—  ro 

O  CO  O 


Id  05  CO  ^  -t< 

0  C-l  O  t~  M 

01  -+  o  ao  'X) 

4t<  rH  O  O 

^1 


-H  T— I  »  ^ 
CI  CO  OJ  t~ 

C-l  O  lO  CO  (M 


1 — ^  CO  "ri  CO  o 

01  t~  OO  ^ 
CO  CO  CO  t~  Ol 

O  . — ^  CO  ■ — ^  05 
r-H  01 


O  00  CO  00  i-M 
-t^  CO  CO  lO  O  l 

CO  o  qi 

T-H  I— I  C-l  .-H  CO 


lO  OS  CO  O  00 
Ol  lO  .— I  00  01 
Ip  CD  00  O 

CO  'do  I— I  o  oi 

CO  CO  lO  00 


lO  OO  CO 

Oi  01  00 
1^  t-  o 


OOOQOOOCO  .— lOXXiO  COO-Hr— iJ:^ 
OOi— i-HCO  COOO-Ht— I  Oil^OTCDO 


-+  r-<  O  CO 

i^T.  -f  O  CO 


X.  lO  o 
O  X' 


crs       O  O 
Ol  CO  CI  X  X) 


X  C-1  CO 
CO  -H  CO 


^  O  CO  — H  O  CO  r-^ 


OS  O        ^  t~ 


X  1— I  lO  t~  CO 
Ol  CO  CD 


00  Oi  CO 
CO 


X  X  CO  1~  CO  lO  C5  lO  CI 

-HXCOOCl  C5C105'*0 
05        ^  CD  in  O  CD  lO 


CO  05  CO  CO  r— I  CI  X  -H  CO  lO  CD  X  CO  Ol  l-O  X  CD  OJ 
CO  O  lO  t~  OT  -*  O  05     lO  CD        O  O     CI  Ol  O  CD  05 

lO  CI  CI  'dH  lO  CO  CO  CI  t~     Oa  CO  CI  CD  O     CO  -f  CO 


lO  O  CO 

lO  o  o 

C  I  CO  t— 


M  05  0>  O 


05  CO  GO  CI 
^  CT  CI  C  I  I— < 


lo  CO  OS  1 — ^  05    05     CO  X  05    lo  05  lo     lo    ^  o  o  ^  o    o  o  ci 


o 

-f. 

CO 

o 

CI 

o 

CI 

o 

-H 

CI 

CO 

OS 

10 

lO 

OS 

10 

X 

lO 

1^ 

OS 

CO 

CO 

Cl 

1 — 1 

CD 

CO 

o 

CI 

lO 

CO 

o 

CI 

1 — 1 

1>" 

X 

CI 

CO' 

o 

~H 

X 

10 

CO 

10 

0 

OS 

X 

lO 

00 

X 

0 

CD 

CO 

lO 

OS 

X 

OS 

X 

O 

OS 

X 

o 

o 

OS 

lO 

CO 

0 

CT 

0 

CI 

C7 

CI 

p 

p 

CT 

0 

00 

00 

00 

CI 

1 — 1 

lO 

CO 

o 

o 

X 

X 

o 

'O 

^ 

-+ 

OG 

lb 

CO 

10 

1 — 1 

1 — 1 

1 — ( 

CI 

CI 

CI 

CI 

CD 

OS 

CO 

CI 

CD 

-* 

CO 

o 

OS 

CO 

OS 

CI 

CO 

OS 

1 — ( 

X 

I— I 

OS  i:^  0 

10 

CO 

eo 

CI 

CO 

X 

OS 

o 

C-1 

^ 

CI 

X 

CO 

19 

p 

-&< 

CO 

cp 

p 

10 

1 — 1 

CO 

Cl 

0 

o 

1 — 1 

CO 

CI 

CO 

CO 

1 — 1 

o 

OS 

CO 

o 

0 

CO 

CI 

ib 

CI 

-H 

cb 

CD 

lb 

OS 

lb 

lb 

X 

■0 

£>■ 

1 — [ 

1 — 1 

CI 

CI 

CI 

CO 

O 

o 

CO 

o 

CI 

OS 

1~ 

CO 

OS 

CI 

lO 

'CO 

-H 

OS 

X 

-t< 

lO 

Cl 

OS 

OS 

CO 

CO 

I— I 

1— 

o 

CO 

£~ 

CO 

OS 

X 

o  t~ 

OS 

X 

CD 

CO 

CO 

0 

OS 

X 

0 

■X 

OS 

t- 

X 

CO 

0 

CD 

X 

cn 

OS 

1 — 1 

cp 

OS 

CO' 

X 

lO 

CI 

CO 

cp 

CI 

-X 

lO 

00 

X 

CI 

CI 

p 

cp 

X 

p 

10 

X  1^ 

Cl 

"* 

CO 

OS 

o 

X 

CO 

OS 

CD 

-in 

CD 

OS 

CI 

lb 

I— I 

0 

lb 

CO 

CI 

'X 

OS 

OS 

OS 

C1 

Cl 

X 

'X 

OS 

0 

CI 

CI 

CI 

1 — 1 

CI 

CI 

CI 

1 — 1 

1 — 1 

1 — ( 

CI 

1 — ( 

CI 

c:i 

CO 

CI 

CI 

1 — 1 

CI 

CT 

CI 

r-H 

1 — I 

(M 

00 

o 

CO 

CO 

CI 

CI 

o 

o 

CT 

OS 

CO 

X 

CO 

CO 

10 

0 

CO 

0 

X 

OS 

0 

-H 

CD 

X 

10 

X 

Cl 

10 

cp 

00 

CO 

o 

OS 

X 

cp 

ip 

-n 

CO 

p 

p 

ip 

p 

OS 

CO 

p 

cp 

10 

cp 

p 

p 

p 

Cp 

CO 

0 

CO 

1 — 1 

lb 

o 

OO 

X 

lb 

o 

CT 

X 

o 

CI 

OS 

10 

X  0 

t- 

CO 

CD 

do 

lb 

r— * 

CD 

CO 

do 

CI 

CI 

1 — ( 

CI 

CI 

CI 

1 — 1 

1 — 1 

CI 

1 — 1 

CO 

CI 

CI 

CI 

CO 

1 — 1 

1 — 1 

T-H 

C1 

CO 

o 

-+ 

CI 

X 

CO 

o 

OS 

CO' 

CD 

0 

-+ 

CD 

-0 

l- 

CTj 

lO' 

05 

OS 

Cl 

Cl 

CD 

X 

CD 

CI 

OS 

cn 

o 

lO 

CI 

CO 

CO 

lO 

t~ 

CO 

-H 

CO 

0 

OS 

CO 

-H 

CO 

CJS 

CO 

0 

CO 

m 

CO 

OS 

CO 

CO 

CO 

-H 

CO 

1 — 1 

lO 

CO 

CD 

OS 

X 

CI 

10 

-H 

CO 

CD 

CO 

t-- 

X 

X 

CD 

OS 

0 

10 

1 — 1 

0 

o 

OS 

OS 

X 

1 — 1 

OS 

OS 

OS 

CD 

o 

lO 

CD 

X 

10 

CO 

cn 

CO 

CI 

CD 

OS 

1 — : 

OS 

CJS 

0 

CI 

CO 

CO 

CO 

CO 

lO 

CI 

CO 

l-O 

CO 

CO 

-* 

-+ 

10 

CO 

10 

CO 

lO 

10 

CD 

1 — 1 

lO 

10 

CD 

I— I 

CO 

1 — 1 

o 

CO 

CO 

lO 

CI 

OS 

CO  1^ 

'O 

X 

10 

0 

CO 

10 

X 

-+ 

-H 

OS 

-H 

OS 

CI 

Cl 

t— 

in 

00 

CI 

CO 

CO 

X 

CI 

CO 

OS 

X 

OS 

CO 

X 

-^^ 

OS 

CO 

"X 

CO 

CI 

CO 

1 — ( 

CO 

1 — 1 

OS 

in 

OS 

ta 

CO 

CI 

CI 

t- 

X 

X 

CI 

OS 

X 

CO  O 

-* 

CI 

CO 

X 

X 

CO 

CD 

X 

6 

-(H 

lb 

I-H 

CI 

0  CO  CO 

CI 

CO 

lO 

-f 

-H 

-^^ 

CI 

-f 

lO 

CO 

CO 

lO 

-+< 

CO' 

lO 

lO 

lO 

lO 

I— 1 

1 — 1 

1 — 1 

10 

>o 

-HOCIOCO'iOCD-H'+'eO  COCOOf-CO  X-*iOSClC1  ClOCO-l^-* 

X  CO  1— H  10  ^     'tH        O  'O  O  lO  p  i;-  p  O  CO  Cl  X  Cl  X  Cl        X  CO 

ibcDOsi-Hco    ocb-^ocD  cb-KCDOso  ibdbcbt^io  -^cbcbibi'-- 

I— I  Cl  CO  Cl     Cl  CO  CO  -+  Cl  Cl  CC  ^  .-^  CO  t— I  TO        Cl  I— I  Cl  Cl  Cl  Cl 


CD  t-  Cl  Cl  CO 

Cl  X  o  CO  ^ 


CD  10  Cl 
10  10  10 


Cl  O  T-H  C"!  O     O  X 


CO 

H 

o 
« 

H 


P5 
H 

I-H 

CO 


o  . 

p  M 


Eh 

u 

M  1 

o 
o 

n  1 

iz; 
<J 

Eh 
M 
H 

Eh 
M 


iz; 
t> 
o 

Eh  _ 


pq  H  Ph 


o 
■J 
►J 
o 


Eh 


h3  w 

w  a 
n  Hi 


<!  O  O 

_  Ph 

n  pq  ^ 

<^  t-"  tij 

w  p5  5 

«  o  3 

C5  cq  S 


M 

<j  , 

t) 

c 

M 

<!  Eh 

.  ij 
EH  <! 


M 

W  Q 
W  M 

o 
o 

iz; 


M 


o  H 


a 

p^ 
o 

p 

m 
Q 
<! 

^  ID 


H  !zi  w 


H 

<!  ' 
c 

iz;  ■ 

o  _ 

Eh  P5 

&  o 


<! 
hJ 
>J 

t— t 

>  1 

o. 
o 

n  ' 

<! 

i  I 

PL.  O 


■  <! 
Q 

pj 
o 
,  ij 

'  Ph 
Eh 

iz; 

.  o 
n 

iZi 

IJ 

J  H 

bLj  I— f 

o  a 
PS  o 


n  n 


:/2  03 


n 

<l 

M  M  w 


I-H 

w 

iZi 

PS 
<j 
m 

p 

Iz: 
<J 

M 

P5 

P4 


Ph  P<  M 


S  w  3 

iJ  5  M 

H  «  o 

M  3  P4 


MCO-*     lOCDt^XOS  Or— 1CICO-+  lOC0t~XO2 


O  ■— I  Cl 
C^  Cl  Cl 


^  10  CD  t—  X 
C<1  Cl  Cl  Cl  Cl 


OS  O  1 — I 
C-l  CO  CO 


52 


■<  E-t  03 
H  W 

s  s  ? 


W  r-ri  - 

0  W  o 

01  hj 


r-H  ,— (  Cq  CO 

03 


GO  C7>  O  T— I 
(M  CO  t--  lO  CO 


lo  o  t—  oo  oi 


ip  c^i  (rn  t;-  r-H 

"^^H 


O      I        CO  '^l 


(Tl  lO  CO  ^ 

CO  lO  if-i 


lO  O  t~  00  CI 


t;  cp  -tr- 

co      00  ei 


OS  , 


«p  5-1  t~  QO 
CO  CO  CO  CO  CO' 


-t<  O  CO 
OT  OT  Ol  (M  5-1 


CO  5-1  r-l 

no      o  »o  lb 


OS  O  ■— I 
5-1  CO  CO 


O  5-1 

do  X'  lb 


t~  CO  5-1  CO  O 
5-1  00  t~  t~  t~ 
5-1  CT5  'Xl  CD  t~ 


CO  cz)  CO  m  'Xi 

lO  CD  ■— I 
10  CD  O 


O  1— I  10  X  5-1 
t-  5^1  .— I  t~ 
CO  5-1  X 


X  ' — I  10 
X  CD  ■— I  OS  X 
CD  10  CI  X 


C5  CO  X  10  O 
I— I  5-1  ^  1—1  10 
OS  CD  O  X  CD 


O  CO  10  ^ 
t~  t-  lO  CO  O 
t-  CD  CD  O  Ci 


.-^  X 
05  .-H 
CD  t~  O 


05 
CO 


i-O 


-*  ^  >o 


10  ^  10  lO 


^        "O  ~*  ^ 


CD 


10  g 


^  X  O  in 

CO'  lO  O  CD  lO 

ic  10  ^  01 


lO  10  O  1~ 
^  ^  CI  CD  CO 

»o     o  »o 

CD  CD  CD  X  CD 


T— I  O  'O  CD  O 
X  ^  x|J  CO  10 
O  C3  X  CD 


O  CD  t~  O  CD 
CO  t~  51  CO  CI 
10  ^  C5  >0 


O  lO  lO  CO  — )H 
O  CD  O  ^ 
1— I  t~  CD  CO  Oi 


10  O  O  O  X 
O  O  CO  t~  t- 
10        51  5^1  5-1 


irj  CO  O 
01  CD  ^ 
51  CO  t— 


o 


51  X  T-H  1— I 


10  ■— I  10  CD 


XCDXCDIO  lOlO'CCDin 


10  O  CD  I— I  CO 
10  X  £~  Ol 
10  X  r-l  O  CNI 

lb  lb  CD  t~ 


X  in  01  CO 

t~  t-  10  ^ 

^  t~  'X  I— I  t- 


X  5-1  CD  O  51 
CD  OS  C5  10  CO 
CO  5-1  51  CD 


lOlOlOCDlO  t~CDCDt^CD 


02  X  O  X 
CI  C5  O  CO  -t~ 
X  O  5-1  CD  i-- 

4t<  t-  in  CD  10 


^  o  o 

5-1  -tH  X  O 
X  5-1  Oi  5-1  O 
CD  CD  CD  CD  lb 


1—1  CO  J:^  X  m 

CI         -rH  CO  C5 
CO  10  51 

^  -^H        CD  ^ 


t~  O  CD 

r-H  X 
X  CD 


o 

CO 
CO 


CO  g 


I— (  51  C2  I — ^  CD 

^  in  ^  X  ^ 

r-H  10  O  r-H  O 

10  lO  CD  CD  CD 


CO  CD  C5  ^ 
^  CD  lO  5-1 
CO  O  Ci  CI  CO 

lb  CD  lb  lb  lb 


10  in  t~  r— I  ,-H 

O  X  O  CD  CD 
CO  X         CO  i-H 


O  CO  CD  51  CD 

CI  X  C-1 
CO  CO  O  O  r-H 


) — ^  Ci  Ci  CD  J:^ 
X  '^l  5-1  X  lO 
C3  CD  5q  i-H  r-( 


CD  t~  C5  t- 
O  C5  10  5-1  O 
CD  C5  01  O 


X  CI  CI 
X  CD  CD 
5-1  C<1  X 


(35 
O 


cDiniocDcD     incDincDin     loincDcDio  ^Tt^coco^^ 


'A 
'A 

1  ^ 

« 

<! 

< 


i-H  in  in  r-H 

CD  ^  5-1  C3 
t~  5-1  C5 

'Jh  lb 


C5  Cl  t~  CD  CD 
^  OS  CD  in  CD 

X  X  5-1  r-H 


CD  OS  'X  in  X 

O       in  r— I  ir- 

X  CI  1>-  r-H  CD 


in  r-H  O  CO  'X 
CO  5-1  CD  CD  r-H 

-t—  r-H  in  o 


r-H  X  O  CD 

5-1  X  O  00  X 

1 — ^  C2  O  r-H  CO 


CO  CI  t~  CO  in 

r-H  CO  X  Cl  O 


C5  -Tin 
C2  C2  J:-- 
CD  5-1 


(M 


^     in  in  in 


^  ^  ^  in  ^ 


^  in  ^  in 


in  ^  in  in  ^ 


CO     ^  in  ^ 


C5  X  Ci  1:^  C5 

CO  CO  CD  in  ci 

CD  Ci  O  O  C2 


in  O  CD  C2  rH 

X  ^     o  m 

CO         5-1  r-H  ^ 


r-^  t~  CO  o  in 

O  O  CO  o 
CD  O  C5  o  ■— ' 


in  in  CD  CO 
CO  in  in  CO  ^ 

O  5^1  X  r-H  r-H 


51  in  ^  t~  oi 

CD        5-1  CD 

^  51   51  ^ 


CD  CD  51  m  in 

O  C3  ^  5-1 

X  5-1  CO  in  r-H 


r-H  CO  CO 

CO  X 

in  CO 


CO 
00 


51  51  CO  CO  5-1 


COCOCOCOCO  C0CO5-1C0C0 


CO  CO  5-1  CO  CO 


CO  CO  CO  CO  CO 


51  51  5-1  CO  51 


m 
H 

o 

r/3 


< 

<! 


1  I  1  M 
M 

m 

I  .  .  H 
m 
O 

o 

.   .   ,  p 


M  H  (L,  W  02 


Eh 
05 
<1 
H 

H 

O 

O 

Q 

<1 

Eh 
M 
M 

M  [-. 


<1  p  o 

1^  P^ 
Q  H 

^  E  w 

ffi     ^  I— i 

Sow 

W  «  H 

M  P3  5 

«  O  g 

C  cq  S 


CO 


n 
o 

h 

<l 
02 

p 
& 
<! 

W 

to 

<l 

g 

> 
1-3 
H 

M 


^1 


IZi  ' 

o  . 

M  CO 


!2i 

lis 

«  P  M 

l=>  H  P5 

<!  !=>  O 
1^  M  O 


<! 

o 
o 

o 

iz; 
<J 

Hh  O 

W  C5 


o 

t-H 

P3 
O 

'  h 

Eh 

I  o 

s 

n 

M  O 
O  ^3 


yi  in 
a  p 
1-3  ij 


W  W  q" 

03  <ri 

M  M  M 

O  O  M 

iJ  iJ  J 

O  O  i-H 

PLi  PL|  H 


HH 

w 

<J 

M 

P 

is 
<! 

M 

<! 

Ph 

1-3 

I— I 
03 
02 
O 


incDt^xci  Or-Hcqco-* 


in  CD  t~  X  C3 


O  ^  51 
51  51  51 


-sti  in  CD  J:~  X 
51  01  5-1  5-1  01 


C2  O  r-H 

5-1  CO  CO 


53 


O  M 

o 

^51 


M  ^ 

S  Ph 


1^ 
o 
o 
p^ 


O 


O  Ph 


Ph  < 


m 

O  9 
H  P^ 

M  Ph 


(1h 
I— I 

o 

I— I 


o 

^  Ph 

m 
o 
p^  w 


-M  O  -t-  O        'O        X>  Ol  O  1— 1  C-1  CO  -H  lO        O        OO  as  O  t— 1  Ol  CO  -H  lO 

Percentage 
of 

Irish-Born 

(Whole 
Population). 

-*OtMC005        lOOOlOOOr-l        ^OOOCDOO        t^OltOCOt^  (M'^'Mt^ai 
^  O  r—l  It- ,00        C<IX^-CO-HHl:--        COCOipcpop        OIOSIO'^CO  0010CO-*'X> 

a>odb<X5-^      "iaicooo      in-rHcodb'M      O'O  t--a5db  lO<^^'^^r^^<^^ 

89-8 

CM 


Q 


P3 


-  5P§ 


OS  CO  05  CO 
<»  CO  ^  O;  iO 
lO  <M  CO  C-l  to 

(f  1  CI  OT  CI  r— I 


O  -H  O  «0  -* 

CZD  CO  ^  00 

-tH  ^  >— I  tM  I— I 

oa  o-i  (fi  <f  1 


CO  C-l  -M  GO  lO 
CO  OS  CI  OS 
OS  OS  1 — ^  lO  O 

O  0-1 


CO  CO  03  o  to 

OS  CO  00  OS 

OS  lO  OS 
CI  01  I 


CI  o  -+  cs  X) 

—H  OS  CO  OS  OS 

OS  o  CO  CO 


OS  -H  CO  CO  OS 
OS  -ti'iM  (M 
id  'to  to  to 


1— I  -tH  lO  CO  OS 
^  to  05  CO  OS 
00  OS  Ir-  00  -H 


00  O  lO  00  OS 
^  00  1-^ 
^  CO  1^  OO  OS 


O  .— I  00  00 
to        to  CO  CI 
to  lO  OS  00 


-+I  -H<  CI  O 
CI  CO  C1  CO  I — I 
to  to  CI  CT  t- 


^       --H  lO 


»0  lO        ^  ^ 


"T+H  "rt^ 


^  ^  lO  lO 


lO  CI  CO  to  lO 
OS  ^  CO  I— I 


to  ^  CO  CT  CO 
CI  CO  to  CI  CI 


-th  CI  00  CI  -th 
lo  o  to  OS  t— 


to  ^  o    I  lo 

CO  to  iCi  lO  00 
CI  1 — \  ^  t — I 


o  1— I  T-M  Xi  xi 

CO  ^  I — ^  CI 


CO 
00 


OS 

to 


o 

CO 


to  O  x:^  I 
1^  CO  to  OS  OS 
1^  O  t-  O  t- 


CI  O  O  CI  lO 
lO        -H  lO 
OS  O  CI  I— I  to 


O  O  lO  CO  CI 
^  to  lO  CO  to 
00  to  CI  o 


t~      I  O 

to  o  to  >— I 

I— I  -tH  tO.^ 


O  ' — '  CO  to  CI 
00  lO  to  00  CI 
CO  CI  CI  ^  to 


CI  T— I  CI  CI 


CI  CI  CI 


lO  CI  CI  CO  ^ 


CJ  ^  to  t—  CI 


1^  CO  O  ^  HO 

CI  CO  O  lO  to 
CO  CI         ^  CJj 


CO  •  CO  00  OS 
CO     :  l:^  CI  CO 

r— I  CO  CI  CO 


crs  T— I      lO  ^ 

OS  r-(  CI  to  t~ 

CI  ^ 


O  •  OS  to  CI 
CO      '■  ^ — I  CO  ' — I 


^  00 
-H 

■■X) 


oo 


OS 
CO 


i  o 


I— I        X  CTS  to 
OS  00  t~  CO 
CO  oo  O  to  CO 

io~  to"  io~  oo" 

CI  1 — ^  I — ^  1 — \  I — I 


.— I  'X  t-  I— I  lO 

CI  CI  00  to 

CI  OS  OS  OS  OS 

lo"  cT  oo"  co"  I— r 


I  lO  lO  J:~ 
-tl  CO  O  -*  CI 
OS  00  I— I  lO  00 
'dn"       ^  to"  CO~ 

T— I  CI 


CO  to  CI  CO 

in  o  o  I— I  o 

r— I  O  OS  OS 

ocrco^cfccrt^ 

r-l  CI  r-l  r— I  ■— ( 


o  o  o  lo  CO 

lO  1— I  1^  o 
CI  CO  CO  CO 

to"  co"  go"  ci"  'XT 

I— I  CI  ^  CI  ^ 


o 


ft 

s 


o  o  lio  to 

-H  CI  OS  ICl 


^  CO  OS  lO  'X 
CI  -#  CO  CI  CI 
>0  CI  ^  CO 


O  to  -H  crs 
CI  t~  to  X  in 


O  -+  -H  -H  CI 

X  o  o  CO  OS 

-H  CI  CI  r- < 


CI  1— I  CO  CI  CO 

-*  CI  'X  o  -tH 

CI  -*  ,— I  CI  to 


H  Oh 

o 
Ph 


OS  OS  ^  lO 
t~  CO  OS  GO  00 

^  to  o  ^  lo 

J>."  Os"  t-"  to" 


to  T— I  X  1—1  CO 
t—  GO  CI  OS  O 
t-  lO  CI  o 

co"x>^ci"i--^ci" 

lO  CO  -*  CO  CO 


t-  00  lO  00  CO 
OS  lO  ^  OS  CT 
t-  CO         ^  ^ 

t-^  lo"  oo"  to" 


to  1^  .-H  CI  CI 
i-H  OS  'X  -o  00 
-*  lO  -H  CO  t-^ 
os'  to^  Cl"  Cl"  Cl" 
CO  CI  ^  CO 


to  ^  to  to  CI 

^  r-<  m  in  o 

00  00  CI  '^l  o 


o  Cl  in  o  CI 
CI  CI  X  to  in 
00  to  1—1  in  to 

-H^"  cT  r-n"  to"  in~ 

I— H  CO  CI  Cl 


to  CI  CI  in  CI 
t-  OS  ^  ^  cq 

CO        CO  CJ  I— I 


to      CO  in  CO 

CI  00  CO  'X  lO 
00       OS  OS  .—I 


00  OS  £~     t^-     to  in  CI  Cl  j>- 


to  i—  m  c)  'X 

X'  -+I  O  00  CO 

00  in  in  o 
o~  in~  co~  to"  in~ 

^  ^  CO  CO  CO 


Cl  t~  CO 
to  1>-  Cl  I— I 
in  1:^  CO  CO  t~ 

1 — ^  in  in  to  in 

CO  Cl  1 — ^  1 — ^  CO 


o 

lO" 


CO 


Cl 


00 

oo  to 


OS  CO  00  to  to 
00  ■— I  ■— I  00  Cl 

CO  CO  ^  in  in 


in  to  1—1 
to  in  in 

OS  OS  ^ 


I— <  Cl  CO  ■— I  OS 

^  O  00  ^ 
Cl  OS  ^  t- 


Cl  Cl  .— I 
O  CO  I— I 
^  X  CO 


o 
to 

CO 


to  o 

00 
OJ 


!>3 


CO 


00  o  in  Cl 
00  to  I— I  o  00 

-t~  ^  1— I  -H^ 

Cl"  m"  Cl"  in"  o~ 

in  CO  —H  CO  CO 


'HH  1^  Cl  to  CO 
^  OS  OS  O  Cl 

m  CO 

t-^  to"  0~  t-h"  Cl" 
CO  Cl  -H  CO 


OS  CO  ^  OS  CO 
O  CO  CO  ^  o 

to  to  OS  OS 

^  oT  as~  to"  ^" 

Cl  Cl  Cl 


Cl       CO  o  to 

t~     o  in  CO 

•X        -tH  £~  CO 

oT  in"  co"  in"  ^" 

CO  Tfl  CO  CO  CO 


^  Cl  I— I 
to  1— <  1— <  I— <  1— I 

in  ^  CO  to 
1— T  inT  in~  m"  co" 

CO  Cl  — I  r-H  CO 


eg 


Cl  1^  Cl  ^  00 
to  CO  1 — ^  Cl  1 — I 

in  CO  in  CO 


r— I  O  r-H  ';0  CO 

CO  to  to  -tH  Cl 

in  'X  Cl  I— I  .—I 


O  -H  Cl  X  to 

OS  o  to  CO 

T— I  ^  CO 


CO  COi  --H  CO  Cl 

'X  Cl  T— ( 
Cl  Cl  Cl 


OS  O  CO  'X 

^  -th  in  ■— I 

GO  CO  OJ  Cl 


to 
of 


03 

< 


!2; 


ClI  E-i 


S  ^  H 

"Si 

►tH 

M 


o  5 


P4  o 


<j  o 
pq  M 


^  M 

Eh  O 
><  O 
Ph 


o 

Eh 

iz; 

o  _ 


a  3  H 

W  <!  M 

O  M  g 

^  g  § 

O  1-1 


M 

n 
o 

P    l-J     U  M 

^  W  C5  M 


!>2 
Q 
iJ 

i  2  :^ 

52  J2 
w  is  a 

^  ^  S 


Q 
I— I 

iz; 
<! 


pi  M  S 


Spq 

kH 

CO  ^ 
l-j  Oh 


O 
H 


I— I  Cl  CO  — 1<  in 


to        GO  OS  o 


Cl  CO  in 


to  t~  00  OS  o 
) — I  1 — ^  I — I  1 — ^  Cl 


1— t  Cl  CO  ^  in 
Cl  c-1  Cl  cq  Cl 


54 


TABLE  IX.— CENSUS,  1901— GLASGOW:  AGE  AND  SEX  OF  THE  POPULATION  IN  MUNICIPAL  WARDS 


MUNICIPAL  WARDS. 


4. 

5. 

6. 
7. 

8. 

9. 
10. 
11. 
12. 

1.3. 

14. 

15. 

16. 
17. 
18. 

19. 


21. 
22. 
23. 

24. 

25. 


DALMARNOCK,  - 

CALTON,  - 

MILE-END, 

WHITEVALE,  - 

DENNISTOUN,  - 

SPEINGBURN,  - 
COWLAIRS, 

TOWNHEAD, 
BLACKFRIARS,  - 
EXCHANGE, 
BLYTHSWOOD,  - 
BEOOMIELAW,  - 

ANDERSTON,  - 

SANDYFORD,  - 

PARK, 

COWCADDENS,  - 

WOODSIDE, 

HUTCHESONTOWN, 

GORBALS, 

KINGSTON, 

GOVANHILL, 
LANGSIDE, 
POLLOKSHIELDS, 
KELVINSIDE,  - 

MARYHILL, 


rWithout  Institutions, 
\Institutions,  - 
J  Without  Institutions, 
\lnstitutions,  - 
J  Without  Institutions. 
\Institutions,  - 
[Without  Institutions, 
\lnstitutions,  - 
(Without  Institutions, 
\lnstitutions, 
rWithout  Institutions, 
\  Institutions.  - 

(Without  Insts.  &  Shipping, 
Institutions,  - 
Shipping, 
/Without  Institutions, 
\lnsfcitutions,  - 

(Without  Insts.  &  Shipping, 
Institutions, 
Shipping,  - 
/Without  Institutions, 
\Institutions,  - 

{Without  Insts.  &  Shipping, 
Institutions,  - 
Shipping, 

{Without  Insts.  6i  Shipping, 
Institutions,  - 
Shipping. 
/Without  Institutions, 
\lnstitutions,  - 
/Without  Institutions, 
(Institutions,  - 
/Without  Institutions, 
\Institutions,    -       -  - 

/AVithout  Institutions, 
\Institutions,  - 
/Without  Institutions, 
\lnstitutions.  - 

{Without  Insts.  &  Shipping, 
Institutions,  - 
Shipping, 

/Without  Institutions, 
/Institutions,  - 

/Without  Institutions, 
/Institutions,  - 

(Without  Insts.  &  Shipping, 
Institutions,  - 
Shipping,         -        -  - 


All  Ages. 


Under  1  Year. 


Males. 


Total  without  Institutions  and  Shipping, 
Total  Institutions,        -       -       -  _ 
Total  Shipping,      -       -       -       -  - 


Total  within  Municipal  Bouxdary, 


2.5,623 
234 
17,020 
1,880 
20,814 
■  205 
17,606 
1,423 
14,552 
845 
19,478 
790 
13,565 
20,512 
957 
24 
15,311 
662 
1.165 
274 
5 

2,138 
150 
5,022 
818 
87 
15,087 
480 
760 
12,886 
65 
10,670 
297 
19,815 
1,006 
22,003 
16,285 
52 
17,838 
828 
17,123 
311 
339 
15,587 
11,267- 
153 
6,267 
.5.471 
227 
16,574 
968 
16 


Females.       Total.    I    Males.      Females.  Total, 


359;679 

12,625 
1,231 


373,535 


27,164 

455 
18,448 

433 
21,296 

213 
18,099 

163 
15,930 

681 
18,266 

882 
13,032 
19,980 
1,008 

16^095 
294 
1.161 
177 

2.471 
61 

4,611 
84 

14,847 
3 
8 

13.563 
46 
14,233 
452 
20,057 
8 

23,444 
17,118 
50 
17,912 
4 

17.263 


15,977 
14,145 
207 
9,050 
10.140 
489 
17,143 
1,012 


381,445 

6,722 
10 


388,177 


52,787 
689 
3.5,468 
2,313 
42,110 
418 
35.705 
1,586 
30,482 
1,526 
•37,744 
1,672 
26,597 
40.492 
1,965 
24 
31,406 
956 
2,326 
451 
5 

4,609 

211 
9,633 

902 
87 
29,934 

483 

768 
26.449 

111 
24,903 

749 
39,872 
1,014 
45,447 
33,403 

102 
35,750 

832 
34,386 

311 

341 
31,564 
25.412 

360 
15,317 
15,611 

716 
33,717 
1,980 
16 


19,347 
1,241 


761,712 


928 
3 

511 
1 

723 

523 
2 

434 
4 

696 
7 

415 
612 
19 

424 

19 
3 

23 

105 


448 


287 

138 
3 

503 

685 
571 
1 

427 
437 


498 
235 
1 

73 

86 

.570 


741,124  10,371 


52 


10,423 


872 
12 
483 
1 

714 

502 

420 
1 

657 
15 
419 
595 
11 

434 
2 

14 
1 

"20 
109 


447 


273 

141 

3 

.551 

672 
520 
3 

403 
426 


466 
282 

82 
91 

'594 
7 


10,187 

56 


10,243 


f 


55- 


)ISTINGUISHI]SrG  THE  INMATES  OF  INSTITUTIONS  AND  SHIPPING ;  ALSO  NUMBER  OF  IRISH-BORN. 


1  4. 

5  9. 

10  14. 

15  19. 

Males. 

Females. 

Total. 

Males. 

Females. 

Total. 

Males. 

Females. 

Total. 

Males. 

Females. 

Total. 

2,810 

2,876 

5,686 

3,197 

3,060 

6,257 

2,806 

2  882 

5  688 

2  592 

2,810 

5,402 

12 

'  17 

'  29 

9 

■9 

18 

5 

15 

'  20 

17 

17 

'  34 

1.655 

1,721 

3.376 

1,878 

1,928 

3,806 

1,736 

1,890 

3,626 

1,746 

1,831 

3,577 

18 

14 

32 

49 

55 

104 

53 

54 

107 

133 

41 

174 

2,433 

2,387 

4,820 

2,650 

2,627 

5.277 

2,284 

2,259 

4,543 

2,080 

2,076 

4,156 

1 

1 

11 

18 

29 

189 

152 

341 

2 

26 

28 

1,780 

1,798 

3,578 

2,050 

1,970 

4,020 

1,815 

1,858 

3,673 

1,721 

1,816 

3,537 

8 

15 

23 

17 

8 

25 

161 

11 

172 

92 

16 

108 

1,425 

1,451 

2,876 

1,645 

1,572 

3,217 

1,365 

1,477 

2,842 

1,390 

1,573 

2,963 

16 

8 

24 

31 

19 

50 

37 

24 

61 

66 

38 

104 

2,136 

2,116 

4,252 

2,287 

2,204 

4,491 

1,910 

2,064 

3,974 

1,877 

1,777 

3,654 

23 

19 

42 

18 

17 

35 

10 

6 

16 

15 

13 

28 

1,375 

1,567 

2,942 

1,647 

1,636 

3,283 

1,512 

1,505 

3.017 

1,408 

1,337 

2,745 

1,913 

1,832 

3,745 

2,215 

2,079 

4,294 

1,970 

2.028 

3,998 

2,088 

2,007 

4,095 

70 

74 

144 

53 

74 

127 

26 

36 

62 

17 

39 

56 
1 

1,464 

1,534 

2,998 

1,720 

1,681 

3,401 

1,527 

1,550 

3,077 

1 

1,583 

1,639 

3,222 

1 

1 

1 

6 

7 

4 

4 

8 

35 

11 

46 

66 

90 

156 

108 

107 

215 

88 

96 

184 

135 

146 

281 

2 

4 

6 

4 

5 

9 

2 

4 

6 

27 

19 

46 

90 

106 

196 

114 

134 

248 

155 

162 

317 

245 

255 

500 

1 

1 

2 

1 

3 

15 

3 

18 

390 

380 

770 

459 

446 

905 

432 

449 

881 

540 

472 

1,012 

6 

0 

8 

8 

1 

9 

43 

15 

58 

1 

1 

9 

9 

1,417 

1,500 

2,917 

1.595 

1,615 

3,210 

1.529 

1,483 

3,012 

1,544 

1,449 

2,993 

1 

1 

1 

1 

9 

9 

1 

1 

59 

59 

1,002 

968 

1,970 

1,217 

1,144 

2,361 

1,197 
3 

1,196 

2,393 

1,391 

1,412 

2,803 
9 

7 

6 

13 

5 

8 

6 

3 

588 

598 

1,186 

730 

851 

1,581 

971 

969 

1,940 

1,211 

1,509 

2,720 

23 

20 

43 

38 

21 

59 

32 

15 

47 

18 

55 

73 

1,795 

1,951 

3,746 

2,130 

2,199- 

4,329 

2,073 

1,974 

4,047 

2,043 

2,000 

4,043 

2 

2 

1 

1 

4 

2 

6 

29 

2 

31 

2,312 

2  242 

4,554 

2,521 

2,557 

5,078 

2,387 

2,319 

4.706 

2,206 

2,262 

4,468 

1,906 

1^908 

3,814 

2,084 

2,048 

4,132 

1,756 

1,789 

.3,545 

1,641 

1,681 

3,322 

7 

2 

9 

8 

4 

12 

10 

9 

19 

5 

8 

13 

1,4:1  1 

l.OO  / 

1,745 

1,781 

3,526 

1,694 

1,761 

3,455 

1,906 

1,910 

3,816 

10 

1 

11 

1,'493 

1,492 

2,985 

1,773 

1,780 

.3,553 

1,685 

1,737 

3,422 

1,891 
3 

1,789 

3,680 

1 

1 

3 

36 

36 

1,615 

1.574 

3.189 

1.844 

1,741 

3,585 

1,627 

1,578 

3.205 

1,576 

1,561 

3,137 

966 

957 

1,923 

1,215 

1,189 

2,404 

1,134 

1,151 

2,285 

1,090 

1,576 

2,666 

6 

1  0 

O  1 

-J  / 

Do 

40 

•39 

/9 

16 

25 

42 

379 

356 

735 

554 

539 

1,093 

622 

644 

1,266 

731 

1,185 

1.916 

325 

290 

615 

465 

468 

933 

481 

534 

1,015 

608 

1,022 

1,630 

1 

1 

2 

5 

7 

3 

38 

41 

1.875 

1,896 

3,771 

1.902 

1,889 

3,791 

1,637 

1.662 

3,299 

1,537 

1,558 

3,095 

101 

94 

195 

126 

147 

273 

64 

'217 

281 

224 

'll2 

336 

34,621 

34,977 

69,598 

39,745 

39,245 

78,990 

36,393 

37,017 

73,410 

36,780 

38,653 

75,433 

287 

274 

561 

411 

420 

831 

654 

600 

1,254 

785 

483 

1,268 

2 

2 

^  105 

105 

34,908 

35,251 

70,159 

40,156 

39,665 

79,821 

37,049 

37,617 

74,666 

37,670 

39,136 

76,806 

56 


TABLE  IX. 


MUNICIPAL  WARDS. 


1. 

2. 

3. 

4. 

5. 

6. 
7. 

8. 

9. 
10. 
11. 
12. 

13. 


20. 

21. 
22. 
23. 
24. 

25. 


DALMARNOCK, 

CALTON,  - 

MILE-END, 

WHITEVALE, 

DENNISTOUN, 

SPRINGBURN, 
COWLAIRS, 

TOWNHEAD, 

BLACKFRIARS, 

EXCHANGE, 

BLYTHSWOOD, 

BROOMIELAW, 

ANDERSTON, 


14. 

SANDYFORD,  - 

15. 

PARK, 

16. 

COWCADDENS,  - 

17. 

WOODSIDE, 

18. 

HUTCHESONTOWN, 

19. 

GORBALS,  - 

KINGSTON, 

GOVANHILL,  - 
LANGSIDE, 
POLLOKSHIELDS, 
KELVINSIDE,  - 

MARYHILL, 


rWithout  Institutions, 
\Institutions,  - 
/"Without  Institutions, 
\Institutions,  - 
rWithout  Institutions, 
\Institutions, 
/Without  Institutions, 
\  Institutions,    -       -  - 
(Without  Institutions, 
\  Institutions.    -       -  - 
(Without  Institutions, 
\Institutions,  - 

{Without  Insts,  &  Shipping, 
Institutions,  - 
Shipping,        -  _  - 

/Without  Insts.  &  Shipping, 
\lnstitutions,  - 

(Without  Institutions, 
Institutions,  - 
Shipping, 
/ Without  Institutions,  • 
I  Institutions,  - 

{Without  Insts.  &  Shipping, 
Institutions,  - 
Shipping, 

{Without  Insts.  &  Shipping, 
Institutions,  - 
Shipping,        -       -  - 
/Without  Institutions, 
^Institutions,    -       -  - 
/Without  Institutions, 
\  Institutions,  - 
/Without  Institutions, 
\lnstitutions,  - 

/Without  Institutions, 
\Institutions.  - 
/Without  Institutions, 
\  Institutions,  - 

(Without  Insts.  &  Shipping, 
Institutions,  - 
Shipping, 

/Without  Institutions, 
(•Institaitions,  - 

/Without  Institutions, 
\Institutions,    -       -  - 
rWithout  Insts.  &  Shipping, 
J  Institutions.  - 
(shipping,    -    -       -  - 


20- 


-24. 


Males. 


Females. 


Total  without  Institutions  and  Shipping, 
Total  Institutions,        .       -       .  - 
Total  Shipping,      .       .       -       -  - 


Total  within  Municipal  Boundary, 


2,497 
42 

1,739 
94 

2,062 

1.935 
100 
1,460 
108 
2,162 
18 
1,516 
2,404 
23 
6 

1,749 
47 
151 
34 
1 

354 
34 
646 
73 
10 
1,718 
33 
156 
1,671 
12 
1,572 
33 
2,365 
59 
2,183 
1,558 
2 

2,288 
53 
1,992 


1,614 
1,033 
11 
683 
612 
19 
1,729 
196 


39,693 

1,013 
249 


40.955 


2,699 
94 

1,873 
13 

1,991 

1,793 
15 

1,780 
174 

1,831 
38 

1,257 

2,152 
72 

1,660 
17 
148 

43 

364 
19 

504 
31 

1,472 
1 
1 

1,574 
11 
1,946 
103 
2,086 

2,391 
1,727 
2 

2,024 
1,818 


1.660 
1,552 
25 
1,430 
1,827 

125 
1,870 

151 


41,429 

934 
1 


42,364 


Total. 


5,196 
136 

3.612 
107 

4,053 

3,728 
115 
3,240 
282 
3,993 
56 
2,773 
4,556 
95 
6 

3,409 
64 
299 
77 
1 

718 
53 
1,150 
104 
10 
3,190 
34 
157 
.3,245 
23 
3,518 
136 
4.451 
59 
4,574 
3,285 
4 

4,312 
53 
3,810 
22 
68 
3,274 
2.585 
36 
2.113 
2,439 
144 
3,599 
.347 
8 


81,122 

1,947 
250 


25- 


-34. 


Males. 


Females. 


4,273 
84 
2,787 
317 
3,372 
2. 

2,987 
272 
2,783 
211 
3,599 
54 
2,188 
3,627 
62 
7 

2.590 
115 
225 
73 

439 
45 
949 
210 
29 
2,650 
101 
290 
2,268 
9 

1,941 

54 
3,450 
222 
3,863 
2,738 
5 

3,311 
205 
2,942 
74 
121 
2,931 
2.012 
15 
913 
905 
45 
3,261 
136 
6 


63,004 

2,311 
453 


83,319  65,768 


4,345 
175 
2,840 
39 
3,353 
5 

2,988 
34 
3,036 
219 
2,981 
87 
1,923 
3.349 
123 

2,609 
65 
196 
38 

528 
20 
721 

,  27 

2,530 
1 
5 

2,355 
8 

2,870 
165 
3,233 

4,260 
2,847 
8 

2,979 
1 

2,843 
2 

2,946 
2.820 

49 
1,664 
2,497 

67 
3.280 
188 


65,993 

1,319 
7 


67,319 


■ontinued, 


35  44. 

45  54. 

55  64. 

1      65  AND  Upwards. 

Not  Known. 

Born  in 

1 

Ikeland. 

Total. 

Males. 

Iremales. 

Total. 



Males. 

Females. 

Total. 

Males. 

Females 

Total. 

1 

F. 

Tl. 

3  265 

6  247 

1  944 

4  065 

1  081 

1  358 

•7  43q 

510 

876 

1  386 

1 

1  ^ 

3 

4  989 

i  4-fi 

69 

115 

13 

32 

45 

2 

13 

1  5 

X  0 

\ 

2 

3 

57 

2  347 

4  525 

1  487 

1.632 

3  119 

875 

1  1 74 

J.  )  J.  1  t: 

2  049 

427 

727 

1  154 

1  1 

2 

3 

(J )  1  (J 

502 

60 

562 

400 

61 

461 

221 

57 

■^78 

92 

38 

1  30 

2,416 

2  504 

4  920 

1  592 

1  636 

1  8-'>4 

436 

685 

1  1  91 

4. 

9 

R 

3  495 

3 

3 

1 

4 

5 

2 

2 

2 

2 

98 

2  168 

2  231 

4.399 

1  351 

1  472 

2  823 

787 

99-' 

U  u  -1 

1  779 

461 

641 

U  T:  X 

1  109 

X  J  X  V/—/ 

28 

38 

6fi 

9  Qf!8 

325 

28 

353 

243 

24 

1  43 

1  0 

J.  \J 

1  53 

59 

2 

fil 

1 

X 

1 

X 

— (OO 

1  834 

2,001 

3,835 

1  214 
1,-1 1-± 

1  •''74 

1,-;  /  ■± 

2  488 

666 

81  9 

1  485 

335 

526 

861 

OU  X 

\ 

1 

L 

2 

X  J  -J  "J  «7 

172 

110 

282 

118 

55 

173 

64 

'>6 

90 

18 

7 

95 

307 

2  306 

2  157 

4  463 

1  478 

1  331 

2  809 

739 

758 

1  4Q7 

988 

U  1  0 

5  RfiS 
(J, 000 

75 

82 

'l57 

119 

90 

209 

158 

1  48 

306 

293 

367 

U  U  vy 

53fi 

1  554 

1  475 

3  029 

1  1  3 

1  026 

2  149 

1  1  51 

X  J  X  X 

935 

398 

9  fiOl 

2  433 

2  389 

4  822 

1  836 

1  771 

1 J  1  1  J. 

3  607 

1  00-^ 

_j  J  X  X  0 

41  9 

U  U 

1  07J- 

1  07 

105 

76 

181 

131 

67 

198 

184 

141 

325 

267 

295 

562 

43fi 

4 

4 

4 

4 

1 

\ 

\ 

a 
\j 

1  947 

2,026 

3  973 

1  288 

1,419 

2,707 

678 

957 

1  635 

341 

584 

925 

9 

9 

133 

51 

184 

122 

35 

157 

72 

31 

1 03 

132 

79 

90i 

1  98 

X  t/O 

142 

143 

285 

123 

108 

231 

72 

66 

1  38 

X  'JO 

36 

4-7 

00 

1  98 

54 

25 

79 

45 

18 

63 

22 

1  7 

3C) 

8 
0 

1  1 
1  i 

qq 

2 

2 

2 

2 

1 

J. 

258 

333 

591 

222 

259 

481 

153 

350 

85 

1  98 

93fi 

28 

8 

36 

13 

8 

21 

9 

9 

4 

X 

(J 

90 
-)\J 

628 

575 

1.203 

485 

455 

940 

'>87 

317 

604 

99 

1 81 

1 0  X 

980 

_j  0  V7 

2 

2 

A 

4: 

1  ^Of> 

J- ,  .J  w  u 

188 

6 

194 

166 

1 

167 

89 

89 

35 

1 

X 

3ri 

907 

18 

18 

15 

15 

5 

5 

a 
u 

1,885 

1,805 

3,690 

1  281 

1,259 

2,540 

717 

788 

1.505 

303 

499 

T:  t/ 

809 

^  q7i 
0,011 

136 

136 

119 

\ 

120 

fiO 

fiO 

\j\J 

90 

—  V7 

900 

152 

1 

153 

65 

66 

29 

29 

A 
u 

u 

2 

2 

fi5 
uo 

1  537 

1,670 

3,207 

1,181 

1  411 

•~>  59-^ 

.1,00-, 

7fifi 

t  \J\J 

O'J  i 

1  793 

36Q 

(i09 
\J\J  -1 

Q7l 

1 
i 

1 
1 

9  1  98 

6 

2 

8 

8 

5 

13 

Q 

tj 

A 

1  3 

X  fJ 

2 

1 

X  0 

1,383 

2,061 

3,444 

1,045 

1,464 

2.509 

676 

1  nfi4 

1  740 

75Q 

1  1  71 

1 
i 

1 
i 

;  49 

35 

84 

30 

20 

50 

12 

12 

24 

3 

87 

2,425 

2,407 

4,832 

1,699 

1  818 

3  517 

919 

1  1  fi4 

2  083 

41  9 

J.  J  WO_j 

1 
i 

A 

4: 

r) 

1  9SR 

275 

1 

'276 

234 

\ 

235 

1  34 

1  34 

4- Si 

^0 

1  qs 

'  2,754 

2,856 

5.610 

1,759 

1,931 

3,690 

929 

1  1  90 

2  119 

403 

1  1  '^1 

1 ,  i  U  'J 

1 
i 

2 

■J 
.> 

9  fiqi 

1^928 

2!039 

3,967 

l'206 

1,'337 

2^543 

643 

735 

1^378 

254 

487 

741 

9  59 
j,.J^9 

7 

7 

14 

4 

3 

7 

3 

3 

6 

1 

1 

1  0 

2,143 

2,131 

4,274 

1,502 

1,628 

3,130 

940 

1,213 

2,153 

471 

695 

1,166 

q  99fi 

223 

1 

224 

196 

1 

197 

99 

99 

42 

42 

222 

2,039 

2,085 

4,124 

1,542 

1,590 

3,132 

926 

1,101 

2,027 

398 

600 

998 

5 

9 

7 

2,820 

82 

82 

77 

77 

37 

37 

15 

15 

70 

56 

56 

41 

41 

15 

15 

2 

2 

42 

1,805 

1,914 

.3,719 

1,189 

1.289 

2,478 

622 

769 

1,391 

265 

479 

744 

1 

1 

1,836 

1,562 

1,934 

3,496 

1,039 

1,188 

2,227 

580 

859 

1,439 

401 

637 

1,038 

630 

8 

22 

30 

15 

11 

26 

5 

2 

7 

5 

2 

7 

26 

782 

1,193 

1,975 

736 

896 

1,632 

498 

586 

1,084 

296 

475 

771 

356 

728 

1,401 

2,129 

606 

928 

1,534 

406 

622 

1,028 

249 

459 

708 

1 

1 

355 

57 

61 

118 

38 

88 

126 

'41 

57 

98 

22 

47 

69 

48 

2,018 

2,068 

4,086 

1,185 

1,245 

2,430 

602 

682 

1,284 

258 

399 

657 

4,374 

68 

71 

139 

23 

15 

38 

17 

10 

27 

5 

5 

154 

1 

1 

1 

1 

4 

13,835 

47,010 

90,845 

30,113 

32,488 

62,601 

16,918 

21,105 

38,023 

8,159 

13,283 

21,442 

47 

58 

105 

62,274 

2,539 

718 

3,257 

2,115 

540 

2,655 

1,381 

533 

1,914 

1,076 

845 

1,921 

1 

1 

3,708 

231 

1 

232 

128 

1 

129 

52 

52 

9 

9 

2 

2 

124 

16,605 

47,729 

94,334 

32,356 

33,029 

65,385 

18,351 

21,638 

39,989 

9,244 

14,128 

23,372 

50 

58 

108 

66,106 

58 


O 


-f        —I  C5 

"4^  c/;  rM  CI 
c/3  r-<  o  O 


05  O  C5  o  o 


a  's>  lo  lo 
I-  c-l  ir.  o  o 

O  O  ^  o  (>1 


(Zj       t--  1^ 

m  Ci  o  (M  r-i 


CO  O  O  CI  o 

<^  CO  ro  CO  oo 

r-'  O  CO  O  O 


CO  Ol  O  -1<  -t< 
t—       C2  Ol 
CO  — '  1^  CD  -O 


<o<N-*     .-HOC3(M'-i  oocomo 


CO  CO  Ol  C5 
^  CO  Ol  CI  CO 
^  01  I—  O  CO 


^  CO  1^  O  CO 

o  oi  ^  00  CO 

OO  l-^  CO  Ol  CO 


1-^  01  CO  TlH 
05  CO  lO 

CO  (M  C3  m  CO 


Ol     o  oi  r-- 

CO  CO  CO  CO 
C-l  C-l  ^  CO  Ol 


c;     CO  CO  CO 

lO  O  CO  O  -H 

0-1  i-H  CO  ira 


>0  0-^»OUO      -^Tj^iOlOCO      I>«iO"^iOt^      I0i0»0»00  lOCOCi-— ilO 


CO  o 

CO 

o> 

CO 

CO 

O 

cn 

O) 

o  o 

s 

o 

rH 

1  -  — < 

o 

CS] 

CO 

00  o 

in 

UD 

o 

.o 

o  CO  C2  o 
CO  o  03  --^  o 

o  c»  Tt* 


CC  O  t-  O  iM 

01  o  CO  CO 

CTi  lO  -d^ 


—  O  05  OD  CO 
CO  O  CO  ^  ^ 

CO  1-^  t~  CO  CO 


— I  -t<  LO  o  CO 

CO  O  CO  O  C3 

C5  CO  CO 


O  C5  — I  C» 
-H  CO  l-O  CI  Ol 
O  -t<  =5 


CO  ^ 
CO  CO 

Ol  o 


'  o        o  lo  o  LO  50     i~-  CO     CO  CO     in  -i<  ■*  CO  o     o  -i'  ^  co  lo     lo  o 


^  lO  C5  CO  O 
CO  CO  CO  o  0-1 
(M  O  </3  C5  l-^ 


r-J  —1  CO  CI  ^ 

CO  CI  —  lO  00 

CO  CO    I  c-l  o 


GO  CO  CO  CO 
-f  O  05  Cj^  Ol 
00  lO  C3  m  05 


o     o  Ol 

^  CO  -H  O 
1—  CO  02  CO 


c:  C2  — I  C2 
CO  C2  o  -h  1^ 

C3  ^  lO  -J'  " 


OOC3C50      C3000<M      0OC3O0      005000      C30  CI  005 


CO  (M  O  CO'  o 
Ol  CO  CO  OO  CO 
CO  — I  03  O  — I 


00      CO  c» 
O  Ol  lO  --<  1^ 
O  03  0-1  (M 


CO  O  i-H  o  o 
CO  O  CO  CO 
LO  OS  00  CO  O 


ira"o-*ioo     ■"fiiOTi'mco  io-*-^ioco 


CO  Ol  Ol  CO 
^  r-^  CO  O 

<p  C3  O  CO  IL-I 

lb  it<  in  LO  lio 


CO  Ol  t~- 
^  O  CO  ^  Ol 
O  Ol       lO  CO 


Ol 


CO      o  o 

rl  Ol  CO  Ol  CO 

C5  O  05  OD  lO 


CO  -t<       O  tH 
O  LO  -t^  o 
C3  CI  — I  o  OO 


lO  CO  CO  C5  CO 
^  O  LO  LO  CO 
CO  CO        C)  CO 


-*  -H  CO  Ol  C5 
CI  LO  -H  CO  o 

00  C5  CO 


CO  C2  Ol  00 

O  OO  C2  O 
O  Ol  l~-  00  LO 


lo  3 
o 


"*^-*^-t<     -^LOLoioio     lOLoiom-*     m-*TiHLOira     ■>i(TtHTt<co-^  -^oo 


■li3;ox 


1(0  CO  CO  r — H 

1^  Ol  C/0  CO  01 

1^  Ol  r-  Ol  CO 


02  CO  CO  00  O 
Ol  -t<  — 

lo  CO  OO  o:. 


00  CO  Ol  OO  o 
1^  -t<  CO  -H  02 

00  r-l  O  O 


O  lO  CO  ^  Ol 

LO  LO  r-H  CO  lO 

CO  CO  CO  o 


-H  CI  lO  Ol 

LO  cn  CO  o  00 

^  Oi  Ol  LO 


Ol 

CO  CO 

r-l 


O  O  O  O  C5 


lOJCsl:^      COCCiOOt^      0000505      O0000C005  coo 


O  O  ^  CO 
CO  Ol  CO  O  Ttf 
Tt<  CO  CO  Ol  00 

LO  lO  lio  I'o  t)< 


cz)  CO  00  CO 

CO  110  O  CO  Ol 
CO  p  C2 

lio  lb  lb  -* 


lO  ^  Ol 
^  CO  lO  Ol  c:!5 
lO  CO  O  »0  GO 


—I  CO  CO  CO  -H 
lO  O  lO  Ol  1(0 
C5  t-H  CO  C5  O 


C5  C3  -f  ^  C5 

C5  Ol  o  CI  Ol 

C5  LO  Ol  ^  (=5 


cO'^ji-^-^co     Tjfioio-^io  -!t<Ti(-^co-* 


lO  Tt^  -H  CO  <Z) 

^  <r5  Ol  CO 
CO  00  ^  o  ^ 


lO  LO  (N  CO 
CO  GO  CO  CO  GO 
O  CO  OD  CO  1-^ 


CO  lO  CO  CO  <3> 
CD  00  O  Ol  C5 
CO  Ttl  ^  LO  CO 


CJ5  Ol  00  — ■ 
(35  lO  lO  CO  O 
■-H  Ol  Ol  1^  05 


IC  CO  >— I  f-H  lO 

IQ  CO  O  CO  lO) 

^  o  o  00 


lO  ^  lO  LO  -H 


LO  lO  -t<  -H  CO        CO  -C  LO  -H  CO 


lO  1(0  lO 


LO  -t<  -t<  CO  ^ 


CO  — I  (15 
LO  CO  CO  LO  lO 

CO     LO  Ol  1(0 


C»  CO  (35  CO 
05  -H  O  Ol  -H 
00  CO  CO  CO  CI 


lO  CO  C2 

00  05  0101  ^ 

CO  CO        C5  CO 


CO  O  CO  CO 
1(3  1-^  CO  CO 
CO  ^  CO  00  CO 


CO  O  CO  t-  H 

lO  CO  CO  r  H 

CO  -*<  -H  Ol 


I010005  lOOOCOCO 


•— I  05        lO  I 


r  -  CO  CO  r  -  I  - 

C5  CO  CO  ^  LO 
Ol  lO  — < 


O  ^  -t<  Ol  o 

LO  CO  1(0  o 
00       i-<  CO  CD 


o  LO  lo  t- 
o  CO  cci  Ol 

05  CD  CO  CO  ^ 


ira  CO  ^  Ol 
CI  CO  OO  1^ 

lO  CO        05  ^ 


CO  05  cn  GO  CO 
—       .-^  o 

lo  CO  lO  <j5  o 


LOLOCOiOlO      lOCOlOLO'^      01-*Ot|iC0      lOlOO'd'iO  U0-*COOllO> 


CO  1(0  CO  (01 
LO  05  (35)  05 
O  Ol  Ol  CO 


C5  Ol  O  t—  CO 
1(0  05  -:t< 
O  CO 


rt<  lO       CI  CI 
CO  Ol  O  CO 
-f        CO  CO  C5 


Ol  (33  — I  o 
^     CO  GO  ira 

CO   UO  Ol   OO  r-H 


CD  lO  CD  lO  LO        CO  CD  LO  LO  Ol        m        01        LO  1(0  CD  -!t<  lO 


Ol  t-^  O  —( 
-t<  CO  — I  1^  -(H 
(Z)  1;--  CO  O  CO 

lb  4t<  CO  (>i  lb 


•Sa'[T3UI9^ 


01  00  CO  —  lO 

I-  ^  -t  Ol  CO 

1^  LO  -h  O 


lO  Ol  C3-.  CO 
CO  CO— ?  -H  O 
Ol  O  Ol  lO 


Ol  CO  lo  CO  Ol 

lO  C5  Tfl  -f  CO 

Ol  (35       -tl  t-- 


lo  o  00  r-  ^ 
(35  Ol  .-I  Ol  CC 
CO  O  ^  00  CO 


CO        (35  O  -)< 

o  CO  cr.  -H  OO 
LO      (35  i-H 


O  05  r-l  O  (35 


l^(35C5CO        ^l:^(35t^'*  050^t^CO 


O  CO  — ' 


C5  Ol  GO  CO  O 
-H  LO  CO  CO  CD 
Ttl  GO  CO  O  1^ 


CD  Ol  -+  -t<  C35 

O  05  Ol  CO  CD 
CO  (ZD  LO  00  (Z3 


O  LO  r-H  O  ^ 

O  -t-  ^  CD  O 
CO  (35  O  CD  ^ 


CO  CO  Ol  O  (35 
C5  CO  — I  OO  CO 
(Z)  C5  L-^  OD  CO 


t-,  CO  -H  CO  CO 
00  CO  Ol  LO  Ol 
O)     CO  00  CO 


lO  Tt<  LO  LO  ^      LO  lO       ^  CO      Ol  CO  LO  CO  Ol 


ri^  T^i  LO  CO  tji  CO  Ol  ^  LO 


CO  CD  00  LO  LO 

Ol  CO  OO 

CO  CO        05  CD 


135  O  lO  Ol  00 
lO  l-^  CI  CO  CO 
CO  -H        CO  00 


CI  00  Tt(  CO  — I 
LO  -(f  CO  OO  o 
135  O  t—  CO 


Ol     CD  Ol 

O  CO  O  TlH  Tf< 

lO  O  1-^  (33  CO 


CO  — 1  lO  Ol 

.— •  O  t~  00  CD 
.— I  CO  -f  O  LO 


lO  ^  LO  -f<  LO  LO  ^        CI  .— I        Tt<  CO  Ol        -t<  LO  LO  CO  -*l        1(0  CO  Ol  Ol  LO  ^ 


O  CO  CO  -H  CI 
^  O      I-^  o 

(Z)  ^  CO  CO 


10  10-^0105 
CO  CO  GO  CO  r-H 
LO  -1  03  I-  H 


CO  Ol  CO  Ol  Ol      CO  CO  Ol  Ol  --( 


CO  —  o  o 

CO  Ol  C5  CI 
(35  (J-1  (35  -H 

<0  (01  (01  Ol 


CO  O  CD  CI  O 
CO  CD  Ol  — 1 
CD  (35  CI  CO  LO 


-fi  -H  Ol  -H  CI 
lO  CO  -H  CO  lO 
O  O  O  — I  T)< 


Ol  Ol  CO  Ol  Ol      CO  CI  -H  -H  CO 


Ol  CI  CO  CO  OO 

1(0  O  Ol  Ol 

■* 

1— <  CO  Ol  CO 

01  o     r~-  (35 

CO  o 

lo  CO  CI 

(33 

l£5 

in 

lO  CO  05  O 

-f 

t-^     OO  o 

CO 

CO  C5  CO  CD 

CO  t-^  1(0  Ol  CO 

CO  OD  CD 

00  . 

O  CO  CO  -*  CO 

LO  ^  CO  CO 

rtn  O  LO 

CO     1(0  -H  Ol 

lO  LO 

Ol  : 

CO 

CO 

-H  --I  O 

O 

-H  — 1  -H  O 

0<Z>  r-^ 

o 

t-i 

00  -H  LO 
LO  -I-  —(  CD  Ol 

-t<     -p  ^ 


TfH  o  — I  o 

-H  CD  -H  LO  -H 
00  lO  LO  CO  00 


C5  o     LO  -H^ 

O  05  C5  CO  LO 

O  ^  O  lO 


-H  t-^  (35  lO  -H 
CO  O  O  05  L^ 
CI  LO      -H  Ol 


,  O         -H  -H  -H  -H  _ 


(Z)  -t<      -H  o 

1^  Ol  1^  l  o  c:5 

lO  05        Ip  ICO 

cb  6  (b 


(3 

< 
■-1 


o  CO  CI  o  o 

CO  05  CD 

-h  O  1(0  CO  CI 


-t<  CO  CO  CO  ^ 
(35  Ci  -t<  — I 
CO  05  CO  Ol  05 


CI       C5  o  ^ 
CD  05  CO  lO 

O  GO  LO  Ol  r-< 


CO  lO  ^  -Tt* 
o  GO      o  o 

CO  LO  Ol  — '  Ol 


GO  CO  1(0 
-H  CO  CO  lO 
CO  CO  O  03  00 


-cH  O 
t  -  (Xi 


O  t-  00  O  O 

CO  CI  J-H 
lO  C»  -H  CO 


CO  Ol  Ol  CD 
O  O  iQ  1(0  CO 
CO  O  CO  1-^  o 


CO  CO  -H  O  CO 
00  CO  O  CI 
CO  -H  -^^^  t--  GO 


JT^  LO  CO  CD  CO 
(35  1 — ^  1(0  05  (35 
CO  -f  1-  CO 


Ol  t—  1(3  CD  CO 
CZ)  CO  — •  lO 
CO  CO  C5  O  — ( 


CD  CO 
110  o 
CI  --1 


CO 

Q 
P3 

>— I 
O 
►—I 

a; 
& 


O  :  iEdg 
O  .jCa 
13  Q<!0 


CO 


^  WHO 

eqeQ<!coai 


gQwc/Tg 


Q 


rH0105Tt<>n      CDt~-00O5O      --'ClCO'^iC  cot^oooo 


o  ;^ 


I  I 


3  .S  .S  % 

-a  ^ 


i-H  01  CO  -*  in 

CO     00  05  0 

f— '  01  CO  "+1  lO) 

CO  t--  GO  C5  0 
^  01 

r-H  01  CO  -H  ira 
01  01  01  01  01 

Inst. 
Ship. 

0  OC       10  CD 
0  0  "  CO  0 
cp  p  0  —  p 

CO 

.   .  .  0  . 

:  :  :  p  : 

01       -H  -(< 

.  ^  .00 

:  p   :  p  0 

CO  CO  0 
—  0    .  .01 
p  p     ;     :  p 

CO  CO 

0    .    .  0  . 

0  — ( 

0  CO 

1 — 1 
p 

0 

00000 

0 

cb     <bi  b 

cb  b  b 

b  b 

b  b 

b 

0 

o 

10  1(0  CO  CO 
■  0  0  0  0 

CO 

.   .   .  0  . 

'.    ;  0  ; 

—<  TtH 

-  01  .00 
;  0    :  0  0 

0  -H  CO 

^0   .  .0 

00   :    ;  0 

CO 

.    .   .  0  . 

I    ;    ;  0  ; 

00 
0 
0 

C- 
0 
p 

H 
O 

cb  0  0  0 

0 

0     cb  b 

b  b  b 

0 

0 

b 

CO  CO  0  0  CO 
0  0  0  0 
(Z>  'Z'  <Z)  <p  <p 

.  (01    .    .  . 

:  p   :   :  : 

CO  01 

00   .  . 
op   :   :  p 

CO 

0    .   .    .  . 

p    :    :    :  : 

10  — ' 

0  CO 

p  -^H 

CD 
0 

0 
0 

00000 

b  b  b 

b 

b  b 

b 

0 

CO 

a 

CO  -H  01  CO  10 

01  LO  CO  o)  01 

CO  01  CO  0  CO 

CO     01  10  CO 

C5  — '  10  CO 
1^  -H  CO  C5  LO) 

CO  t-  0  -H 

C5  0     t—  — < 

Cl  (^  CO  CO 

-H     CO  01  01 

^  CO  —  CO  0 
10  Ol  01  (33 

10  -t<  10  C2 

10  CO  CO  CO  --t 
CO  0  0  1.0  (75 

(33  liO 
01  Ol 

CO 
(50 

GO 
CO 
p 

PS 

C-1  CO  0-1  CO  CI 

r-H  CI  CI  01  CO 

Tfl  Cl  (?1  CO  Tt( 

01  01  01  CO  01 

01  -t^  0  rH 

C3  0 

CO 

0  0     10  CO 
CO  10  01  0  01 
p  0  p 

CO  CO  "01  C2  0 

CO  CO  CO  10)  CI 

p  01  p  O)  p 

01  C3        CO  CO 
lO  1-^  CO  1-  H 

-fi  00  p  01  p 

0        CO  TtH  10 

C»       10  ^ 
p  p  ■+  p 

00  t-     0  CO 

—  0  0  'il  00 

ip  1-0  th  p  7< 

CO 

CO  . 

CO  : 

CO 

Oi 

c- 

10 

00 

a 

'A 

Cl 

01 

(>i        c<i  CO 

Ol  (CO  (N 

-* 

1— 1 

i-H 

lO 
CD 

CO  -t<  10  — '  0 
CO  0  CO  CI  0 
C5  01  0  01  0 

CO  -ti     CO  CO 

0  CO  —  CO  -f 

1^  00  0  0  1.0: 

-t<  CO  01  1(0  CO 
-fi  01  f-H  crs  CO 

00  0  0  CO  CD 

-H     0  CO 

CO  CO  CO  —<  i-O 
0  00       CO  ^ 

0  CO  CO  10  CO 

CO  1^  CO  0  0 
00  0  03  0 

^  LOl 

CO  01 

r— 1 
r-t 

CO 
C<J 

0  ^  -H  ^  ^ 

0  0 

0  0  — ( 

0  ^     -I  0 

0  0 

■-I 

I-H 

CD 


0  01  CO  01 

01  1^  CO  CO  1^ 
CO        CO  C3  CO 


CO  00  -H  CO  CO 

CO  CI  CO  o  CO 

O  CO  Ol  01  03 


-H  O  CO  -H  t-- 
C3  1^  0 1  OT 

O  CI  O  iQ  o 


-H  01  CO  01  1.0  1^  CO  £^  10  00 
CI  CO  01  01  c;3     O  CO  I-.-  CO  O 

01  CO  ^  O  CO       -^t  CO  O  10  CO 


CO  o 

C-.'  o 
CO  ^ 


■ct<  O  ■<1<  ^ 


CO  Ttl  O  1.0  i.O  CO  O  CO  CO      LO  O  l-O       '(ft  IC      CO  CO      o  ^ 


01  o  01  c^i 
1^     01  1^  00 

10  CO  10  1^  CO 


CO  01  CO  00 

O  O  lO  -K  CO 
O  r-<  1^  O  OD 


-f  — (  01  00  CO 

03  CO  ^  l-^ 

CI  Ol  o  CO  01 


(33  00  ^  CO  CI 
—  O  (33  O 
(33  CO  01  CO  01 


CO  -H  CD  -h  CO 

CO  OD  OJ  CO  01 
CO  CO  C3  O 


CI  CO  01  CI  01     Ol  01  Ol  CO  01     -ti  CO  01  CO        01  01  01  CO  CO     01  CO  CO  CO  01 


CO  O  -t(  10) 
-ti  CO  ^  O  cao 

O  Tt<  GO  CI  — ( 


CO  CO  10  o  10 

UO  01        O  33 

O  01  -t  ^  o 


0  CTJ  CO  CO  -H 

0 1  (33  C:3  p-i 
CO  O  CO  GO  1^ 


10  -+I  O  (33  CO 

o     01  01  o 

CO  O  (33  CO  CO 


.-(  01  — (  10 
CO  10  o  00 
C3  01  01  CO 


01  01  r-(  01  01        01  01  01  CO     CO  Ol  01  01  01     01  01  . 


^  01  CO  01  ^ 


CO  0 


r-H  -+<  CO  t—  01 

0  C3  CO  0  CO 

1  ^       0  33 

CI  0  CO  0 

CO  0  01  CO 

-tH  0  C3  CO  C3 

CO  00  lOi  0  m 

CO  10  CO  0  1^ 
CO  0 

r-H  0  CO  10  CO 

01  01      10  0 

GO  — '  CO  1^  — ( 

—  -i<  10  CO  r- 
10  CO  1(0  Ol  0 
CO        CO  CO  C 1 

CO  10) 
01  33 
1^  CO 

CO 

m 

! 

1^  (Z)  t—  OD 

l-^  00  CO  CO  C3 

0  0  CO  (33  0 

CO  CO  t—  CO  CJ3 

1^  00  0  C3 

CO  b 

00 

CO 

CO  01  10  CO  C3 
^  0  CO  01  1^ 
0  CO  CO  -H 

CO  CZ>  -+I  C3  CO 

Ol  10  1^ — •  -v 
10  00  CO  LO  CO 

CO  CO  10  cr3 

"  Ol  0  CO 
CO       01  CO  CO 

0  C3  CO  -t<  -H 

CO  -f  0  1(0  01 
0  01  O'  10  0 

10  0  -H  Ol 

CO  1^  10  -H  (33 
O'  CO  CO  C3  CO 

C3  CO 

1-  0 

-;H 
OD 
CO 

CO 
CO 
CO 

i 

^      CO  ■+ 

CO  CO  tK  Tt( 

1.0      Tfl  IJO  0 

Ttl 

0  1.0)  CO 

01  0 

CO  01  —1  CO 

CO  C3  GO  CO  CO 
CO  rH  (33 

CO  01  -t*  ^  CZ3 

^  01  CO  0  CO 
(33  Ol  0  ^  01 

r-  ijO  c;3  10  CO 

~  CO  t  ~  -.O  (33 
CO  0  01  -f  -H 

— 1       0  — '  -H 

CO       ^  0  CO 
CM  00  CD  01  -H 

1^  cr3  'O  01  1(0 

■CO  CO  0  CO  —1 
1^  0  CO  CO  10 

01 

CO  — ( 
C3  CO 

CO 
CO 

0 

CO 

CO  -T  CO  CO  CO 

CO  •*(  -t<  Tf  i-o 

rf  0  -i<  Tt< 

'^l  CO  CO  Tt(  ^ 

CO        -*  CO  CO 

22 

s 


o 


X! 

PQ 
< 


'cf" 


CO 


-H  CO  -t<  O 
CO  O  CO  01  00 
00      O  CO  iQ 


10  O  O  O  CO 
01  CO  o  o  10 
CO  (33  CO  01 


CO  GO  r--  10  o 

01  (/2  01  01  CO 
CO        CO  ^  CO 


(33  -t(  O  10  CO 
-tl  10  (33 
CO  33  3;  33 


M  t  ^  -+I  GO  33 
Z)  lO  (33  CO 
.*        00  CO  ^ 


10  10 
CO  S3 
CO  CO 


'  01     01  01 


'-'—(—(  01  01      01  01  01  01  CO 


— (  CO  Ol  CO  01 


1(0  t--       GO  10 

(Z)  r-H  -+  CD 

.-1  CO  (33  01  10 


10  CO  o  — '  00 
^     o  o  -t< 

0  (33  -1<  ^ 


10)  C3  O  -H  CO 

01  CO  CO  r-i 

01  C3  O  CO  01 


t-  H  -H  — (  CO 

CO  CO  O  CO  CO 

o  Ol     cr3  o 


-H  C  O  if5  -H 
CO  —  CO  I—  CO 
O  CO  C3 


CO  CO  10)  CD  O 


10  10  10  CO  CO        1--  LO  CO  O  GO        CO  CO  CD  lO  CO        CO  CO  CO        CO  o 


C3  — (     01  CO 

-t<  CO  1^  ^ 

CO  r-H  O  O 


O  CO  C3  133  10 
^  -t<  O  33  O 
— (  CO  O  r-.  — 


LO  CD  10  CO  CO 


O  LO  CO  CO  CO 


CO  (33  1^  r-(  -+< 
33  -H  33  —  LO 
10  to  (CI  00  10 

0  CD  CO  LO  10 


01  O  01  -tH  ! 

CO  CO  33  ( 
O  O  I-  33  1 


CO  r~  no  CO  10 
p     O  -o  go 


O  CO  10  LO) 


CO 


0  10  O  -H  O 

01  CO  1-^  CO  C3 
CO  GO  C3  t--  O 


CO  CD  00  -tH  O 

CO  LO  01  10  o 

TtH  -H  Ol  LO)  ^ 


^  CO  10  C3  33 
CO  CO  O  r-l 
C?3  CO  CO  CO 


i-l  -t<  O  -t<  -tl 
CD  t^.Cl  03  01 
I  -  GO      LO  CO) 


O  10  -H  01  O  CO 
—  —  01  33  O        CO  CO 
O  O  C/;         -tH  1^0 


CO  10  LO  CO  C3 


1^  LO        CO  00 


O  t—  (33 


o  r-  CD  CD 


^  1^  Cl  CO  o 

CO  O  CO  CD  CO 
Ol  O  C3  CO  C3 


CO  O  r— I 

(33  CO  t-^  O  01 
CO  CI  CI  CO  -t< 


CO  O  (01  -H  10 
O  GO  10  O  01 
-P        -tl  C3  10 


CO  Tt<  CO  CO  CO 
O  01  CO  CO 
r-l  CO  LO)  CO  Ol 


CO  -f  10  CO 
CO  (33  CO  Ol 
CO  O  CO  33  i-^ 


oooor^cO(33     L-1--CO00GO  1— ii^<Z)oo^     (X3     M  00        a  ^  o  10  a 


CO  i  _0) 

o  b 


10  GO  00  CD  O 
C3  10  O  CO  CO 
O  CO  O  CO 


o  CD  r~  CO 
CO  01  10  -l<  I- 
O  Cl  <33  II  CO 


10  — (  CO  10  rH 
CI  LO  10  33 

1.0  CZ)  00  1.0 


CO  O  l-^  — 1  CD 
LO  O  C3  CO  10) 
CD  10  >— (  CI  LO 


0  CO  o     01     10  CO 

CO  —  CO  03  -P  O 

01  C3  C3        CO        C3  10 


COl^COCOC3        (3300000303        OSOOOCOl^  COCO00C3CO 


05 

-t: 


Oh 
O 


CLiOOJX) 


o 

H 
.55 


CO 

Q 


CO 

!s:  : 
o  ;^ 

HO-c 
Sco 


<  01  CO  rjl  in      CD      00  (33  O  01  CO  -t<  LO 


60 


TABLE  XI.— CENSUS,  1901— GLASGOW :  NUMBER  OF  INMATES,  WINDOWED  ROOMS,  AND 
IRISH-BORN  IN  INSTITUTIONS  IN  EACH  MUNICIPAL  WARD. 


Number  of  Inmates. 

:land. 

Rooms. 

MUNICIPAL  WARDS. 

Name  of  Institution. 

o5 

>^ 

<u 

s 

0) 

-tJ 
O 

H 

a 
o 
pq 

c 

1 

DALMARNOCK,  ... 

Belvidere  Hospitals, 

234 

455 

689 

57 

327 

Lodging-House,  20  Moncur  Street, 

4 

263 

267 

43 

14 

Do.,          66  do., 

193 

193 

42 

11 

Do.,           179  Great  Hamilton  Street,  ... 

700 

700 

155 

11 

2 

C  ALTON,  ... 

Do.,          52-58  Clyde  Street,   

363 

6 

369 

120 

12 

City  Orphan  Home, 

88 

35 

123 

1 

52 

Lodging-House,  45-49  Greendyke  Street, 

282 

4 

286 

122 

12 

MILE-END,  1 

.  Family  Home,  St.  Andrew  Street, 

250 

125 

375 

21 

176 

3 

Catholic  Orphanage  for  Boys, 
Do.            do.  Girls, 

205 

5 

208 

210 
208 

14 
14 

21 
29 

Slatefield  Industrial  School, 

175 

2 

177 

9 

32 

Old  Barracks,  Gallowgate, 

57 

75 

132 

2 

60 

Lodging-House,  48  Duke  Street, 

206 

1 

207 

37 

15 

4 

WHITEVALE, 

Do.,          39  Watson  Street, 

352 

352 

66 

8 

Do..          21  do.,   

519 

1 

520 

134 

s 

Do.,          14-16  do.,   

111 

111 

33 

4 

Mission  Hall  for  Friendless  and  Fallen  Females, 

3 

84 

87 

7 

27 

{ 

Glasgow  Royal  Infirmary, 

375 

363 

738 

93 

206 

5 

DENNISTOUN,      ...  i 

Drygate  Model  Lodging-House, ... 

365 

4 

369 

149 

16 

i 

H.M.  Prison,    

105 

314 

419 

65 

643 

ClPPT'MTJ'RTTP'M  J 

St.  Joseph's  Home, 
Barnhill  Poorhouse, 

104 
686 

137 
745 

241 
1,431 

190 
346 

48 
85 

8 

TOWNHEAD,        ...  | 

City  Poorhouse,  ... 

Fever  Hospital,  Parliamentary  Road,  ... 

Old  Man's  Home  and  Asylum  for  Old  Women, 

863 
94 

804 
204 

1.667 

298 

426 
10 

256 
122 

r 

126 

75 

201 

18 

77 

Lodging-House,  173  High  Street. 

168 

2 

170 

65 

5 

Q 

Do.,         195-207  do.,  '   

Do.,         34  Stirling  Street, 

1 

192 

145 
3 

146 
195 

16 

.  36 

18 
33 

Do.,         6-14  Miller's  Place,      ...  ... 

80 

34 

114 

39 

12 

1 

Central  Police  Office, 

95 

35 

130 

24 

83 

1  n 

iU 

JbAL>±lAJNlir£i,              ...  y 

The  Night  Asylum  for  the  Houseless,  ... 

164 

90 

254 

63 

57 

Hotel,  

110 

87 

197 

36 

282 

i  i 

JSJjX  Ixlb  WUvL',        ...  y 

Hotel,   

Y.M.C.A.,  100  Bothwell  Street,   

29 
121 

48 
13 

77 
1.34 

18 
2 

91 
208 

{ 

Lodging-House,  28  M'Alpine  Street, 

314 

2 

316 

83 

16 

12 

EROOMIELAW,  ... 

James  Watt  Street  Home, 

377 

2 

379 

103 

16 

1 

Hotel,   

127 

80 

207 

21 

379 

13 

ANDEKSTON,        ...  | 

Hydepark  Lodging-House, 

347 

2 

349 

129 

17 

Clydesdale  do., 

133 

1 

134 

71 

7 

14 

SANDYFORD, 

Eye  Infirmary, 

65 

46 

111 

13 

65 

15 

PARK,   1 

Western  Infirmary,        ...        ...        ...  ... 

Sick  Children's  Hospital, 

253 
44 

382 
70 

635 
114 

80 
7 

S81 
93 

Lodging-House,  51  North  Woodside  Road, 

352 

6 

35  y 

60 

11 

16 

COWCADDENS,     ...  | 

Do.,         1  Burns  Street,... 

399 

2 

401 

74 

10 

Do.,         16  Garscube  Lane, 

255 

255 

64 

9 

18 

HUTCHESONTOWN, 

Sanitary  Reception-House, 

52 

'  50 

102 

10 

19 

19 

GORBALS,  1 

Carlton  House, 

Lodging-House,  Portugal  Street, 

403 
425 

4 

403 
429 

104 
118 

12 
24 

20 

KINGSTON,  

Lodging-House,  Centre  Street,  ... 

311 

311 

70 

12 

22 

LANGSIDE,.  1 

Victoria  Infirmary,         ...        ...        ...        . . .  1 

87 

131 

218 

24 

206 

"T"\             P                  T      T-\                1          1             i   *J_        J_-  1 

Deal  and  Dumb  institution,      ...   ! 

66 

76 

142 

2 

68 

24 

KELVINSIDE,       ...  | 

Training  College,            ...        ...        ...        . . .  | 

Royal  Asylum,  Gartnavel,         ...        ...        ...  1 

Girls'  Industrial  School,  ...        ...        ...        ...  | 

227 

160 
329 

160 
556 

32 
16 

94 
347 

200 

200 

3 

70 

Magdalene  Institution,  ... 

102 

102 

7 

23 

25 

MARYHILL,         ...  ] 

Eastpark  Home,  ... 
Maryhill  Lodging-House, 

44 
98 

65 
4 

109 
102 

3 
33 

46 
10 

Ruchill  Fever  Hospital,  ... 

269 

497 

766 

53 

415 

Government  Barracks,  ... 

557 

144 

.701 

55 

284 

Total, 

12,625 

6,722 

19,347 

3,708  1 

5,695 

61 


M 

O 
I— I 


O  H 

si 

H  O 

o  W 

m 
O 

o 
fi 

o 
ft 


W  o 


I — 1 

CO 

o 

CO 

o 

o 

C-1 

CO 

CD 

03 

o 

CO 

1 — 1 

1 — 1 

CM 

(M 

) — I 

o 

o 

CO 

1 — 1 

CO 

»iO 

CO 

o 

CO 

G5 



o 

-H 

~v 

0 1 

Ol 

CO 

Ol 

CO 

TP 

— ^ 

0"1 

CO 

Ol 

CO 

00 

lO 

00 

O 

00 

03 

(M 

00 

o 

[>» 

^ 

lO 

Ol 

CO 

1 — 1 

t — 1 

CM-fM 

1 — 1 

CM 

1 — 1 

CM 

CD 

<M 
t>^ 

CO 

^ 

00 

lO 

lO 

CM 

CO 

o* 

CO 

'SKOO'JJ 

CO 

i>- 

CO 

CO 

CO 

c^ 

O 

CO 

GC 

o 

JO 

CO 

r-H 

<J5 

03 

CO 

CO 

05 

CM 

00 

1 — 1 

1 — 1 

r-H 

1 — 1 

] — 1 

1 — 1 

1 — 1 

1 — 1 

CI 

I— 1 

CM 

1 — 1 

T— ( 

1 — 1 

1 — I 

CM 

1 — 1 

1 — 1 

o 
-it 

i~ 

o 

lO 

-H 

CO 

CO 

CI 

CO 

-H 

CO 

CM 

b- 

CO 

o 

CO 

-H 

CM 

1 — 1 

rH 

■RIMVXiaVHNI 

GO 

o 

CO 

o 

o 

CO 

CO 

-H 

o 

-H 

o 

GO 

CO 

1 — 1 

I — : 

CM 

1.^ 

1- 

lO 

CO 

CO 

CO 

OS 

C0__ 

CO 

CO 

CO 

I— 1 

icT 

o" 

co" 

cm" 

'^'^ 

cjT 

ccT 

co" 

1 — 1 

id" 

co" 

lO 

CO 

CO 

CO 

CO 

CM 

CO 

<M 

CM 

CM 

CO 

'TtH 

CO 

CO 

CO 

CO 

CM 

1 — I 

1 — 1 

CO 

Oa 

t~ 

as 

lO 

00 

00 

CO 

CO 

-cH 

CO 

CD 

CM 

CO 

-M 

Ol 

CI 

CD 

CO 

lO 

CO 

■sasnojj 

CO 

OS 

00 

OO 

lO 

CI 

-H 

lO 

O 

t~ 

Oi 

CM 

tM 

00 

CO 

GO 

o 

JO 

ir- 

CO 

CO 

CO 

CM 

o 

CO 

l- 

CO 

CM 

-Ij 

03 

C33^ 

co" 

co" 

CO 

co" 

of 

erf 

in" 

1 — ( 

rH 

CO  r-(  03 

00  -H  CM  CO  GO 
CD  O  CO  03  1^ 


r— I  CO  CI  O 

1-^  CO  CI  O  CO 
00  CO  03  O  CD 


03  I— I  lO  CO  lO 
lO  CD  1^  t~ 
O  CO  CI  CD  CO 


-H^  CO  CO  CO  ■— I 
C03  O  CO  CI  C  I 
O  r-H  CO 


CO  -H  CI  O  CO 
C  I  CO  03  -tH  CD 
CD  03  CO  -tH  lO 

T— T  oo"  cS  >— h"  ccT 


05 
CO 
CM 

OO 


-f  -H  -H  -H  CO 
03  CO        O  1^ 
CI        ^  -+I 


■X  O  -H  o  era 

-+  CD  CO  r-H  CO 
T— I  CI  CI 


03^0010 

<73  O  CO  03 
CI      CI  00 


<33  00  O  CO 
O  r-l  CI  CO  i-H 

CO  lO        O  C  I 


— H  O  lO  CO 
1^-1 — I  CO  1 — ^  CO 
C  I  CO  CO  O  CO 


CO 
CM 
03 


'^i  t~  iX)  i-^  1^ 
CO  ^  ^  >-H  CO 
J>-  O  O  O  03 


(03  J:^  03  -H 
^  CO  CI  1 — i  CO 
O  >0  CM  03  CO 


lO  ^  CI  CO  CO 
CD  CO  C  I  O  CO 
r— I  CI  CO  t~  CO 

I— r  I— r  ci"  cd" 


-rtt  03  CO  CO  CO 

^  03  i-  H  CO 

CT  00  CT  CI  03 


-tH  CI  X:^  lO  CO 
O  O  ^  CO  Jr- 
O  -H  CD  CO 


CD  lO  00  CO 
CO        CO  o  -* 
i-H  CI       CI  I:^ 


lO  CD  CD  r— I  lO 
£~  00  CI  Cr3  CD 
I—I        lO  C  I 


CO  CI  CI  CO  GO 
CO  'CO  CO  CO  O 
CI  1— I  CI  ^  -Tfl 


lO  GO  O^  CO  CO 
no  CI  CO  .CO 
CO  lO        CD  CO 


CO  ^  I— I  .GO  03 
CO  O  '00  CD  03 
lO  CO        CO  CO 


CO 
CO 
05 


CS3  CD  -H  CT  1^ 
-H  O  CO  -H 
O  1—  O  03  CO 


lO  -H  lO  CD  CI 
CD  O  ^  CO  ^ 
03  CJO  ^  lO  CO 


OC0OJ^03  --+10000 


-H  I— I  CO  t-  CO 
03  ^  CJ3  J:— 
1^  )0  lO  03  CO 
cf  t-^  CO~  -H~ 


CO  O  -H  -H  lO 
03  LO  CI  tj3  CO 
O  O  i~  LO  CI 


LO  O  CI  O  CI 

O  1  H  O  03 

'CO        LO  t-  CI 


03  ^ 

CI  Ir-  O  I— I 

03  1— I  00  <03 


o  >o  CO  .  CO  o 

O  CD  t~  -t^  O 

GO  03  ^  03  I — I 


03  03  lO  LO  LO 
LO  CO  CI  CO  CI 
I — I        CO  CO  03 


CD  lO  c:rj  o  CI 

CO  CO  .X)  1 — ^  LO 

^  CO  lO  r— I  T— 1 

T— r  cf  cT 


OO  CI  CO  -H 

1^  LO  I— I  ^  CO 

-tH  <J3  I— I  — H  ^ 


in 
o 

00 
C<1 


O  I— I  cJ3  lO  O 

t~  <03  o  1^  o 

CO  O  CO  CO  O 

cToo^LO^os  c  i" 

CO  1—1  CI  1 — ^  I— I 


00  CO  LO  CI 

t~  CI  LO  -H  I— I 
. — ^  03         CO  LO 
Co"  »0~  1— r  CD~ 
CI  .— I  CT  T— I 


-tl  CI  CI  LO 
-H  LO  Cj3  LO  00 
LO  CI  CD  LO 

-H~  lCs"  03"  cf 


1 — I  O  .Xl  GO  03 
03  C71  10  00  CI 

CO  o  CO  c:73 
cd"  -t^^r-Tcf  co~ 

CM  CI  CI  I— I  T— I 


-H  CI  r-H  -H 

03  CO  CI  O  O 
I— I  CI  00  CO  10 


CD  t~  CO  r— I 
-H  CO  CI  CD 
r— I  CD  CO  03 

cd'  co"  ^  co"  cT 


CO  CI 

Ttl  LO  LO  i>-  1 — I 
O        CI  1— I 

co"  ccT 


10     o  10 

CO  CD  T— I  I— I  O 
I— I  00  CI  O  1— 


-tH  ^  10  (03 

J:^  .— I  t~  1— I 

O  T— I  1—1  CO  00 

Lo"      cf  cf 


10  t~  CO  CO  I— I 
GO  ^  CO  -t—  CD 
LO  10  T— I  I— I  GO 


CO 


00 


O 

G5 
m 
<  o 

I  <^ 
O 


in 

O  m 
I  ^ 


H 
H 


o 


CO 

ft 

Ph 
I— I 

o 

1—1 


CO  t—  CT  CO  Cj3 
CI  CO  CI  03 

O  03  COl  00 


CO  1—1  CI  —H  00 
r-<  CO  -sj^  O  O 
J.^  01  i-H  CD  CI 

t-^'  co"  LcT  id" 


1^  10  !03  CO  O 

-+  o 

t—  10  CO 


O  03  03  CO 
X—  O  O  <J3  CO 
C33         03  X-^  00 

CO  id"x-^  CCj"  co" 


CO  —H  CI  10  CI 
CO  03  1—1  CO  GO 
CI  ^  1—1  ^ 


00 


o 


CO  CO  CO  x~ 
X^  O  C  I  CO  CI 
I— I  CO  CO  X—  CD 

-h"  ci'  CO'"  1-h" 


o  o  LO  1— <  x^ 

CO  03  CI  X—  x-^ 
CI  I— I  X--  X— 


CO  X^  10  CD  -H 
1 — ^  lO  CO  <03  CI 
CT  CI  X^  1—1 


CI  O  <73  CD  -H 
O  X^  CO  00  C03 
C  I  x-^  ^  CX  1— ' 


CO  -*  <33  LO  CO 
LO  t~  CO  1 — \ 

01  o 


03 
O 

of 
eo 


M  S 

S  "  I 

g  g  § 

S  P  P 


o 
o 
o 

W 
H 

ix  -  . 
J  «  55 
M  M  <! 


O 

Eh 

is; 

o  . 

H  S3  ^ 

!zi 

MOM 


O 

Eh 

M 


M 

a 

w  w  H 

P  M 


t5  J 


!5 

<!  O  M 
M 


Eh 


CT  CO  -^^  10 


CD  X^  CO  CT3  O 


^  CT  CO  — H  LO 


CD  X-^  CO  C03  O 


1— I  CT  CO  -H  10 
CT  CT  CT  CT  CT 


62 


<M  CO  lO 


CO        CO  CI  O 


CI  CC.  ^  lO 


CO  t~  00  o 

,— I  r-l  ^  C-l 


^  TO 

CI  c-i 


■H  lO 
1  C^l 


^  9 
PS 

B  Ah 


O  1— I  CvT  O 
O  t-  05  »0 
CO  1-^        CD  i^H 

1— I  lO  O  <M  OJ 


GO  CO  ^  no  lO 

0  t-  ISO 

CO  CO  t~  CO  O 

01  I— I  -^^  CO 


CO  CO  03  05  <M 
t~  CO  lO  1:—  CO 
CO  05  C-1  CO  CO 

-+I  CO       t~  ■— I 

T— I  ^ 


CO  03  1:  H  IM 

O  r-H  O  CO  CO 
lO  CO  -*  I 

lb  CO  o  o  ^ 


00  CO  lO  <M  00 
lO  lO  ^  OO  CD 
1—1  CO  OO  (M  lO 

lb  lo  t--  CO  o 

CO  CO  I— I 


(M  CD  GO  05  CO 
CO        ^  CO  C-1 

O  CO  O 


O  <M  (M  >— I  1— I 
05  1 — I  1 — ^  CO  CO 


^  1— I  o  m  05 

CO  05  t;- 

lO  CO  CO  lO  lO 

CO  1 — ^  CO 


05  05  t~  CO 

CO       CI  CO  o 

CO  lb  o  CO) 


CO  CO  O 
o  CO  m  ip  CI 

Ol  CO  CD 


lO  CI  r-i  tri  -* 

GO  CD  O  CO  1—1 
-tH  CO  CO  CI  o 
t— I  1— I  ^  CO 


CO  O  O  05 
05  CI  J^-  .— I 
CO  O  03  1— I  CD 
CI  CI        CO  lO 


O  C5  O  05 

t  1— <  CI  in 

CI  00        CI  lO 

lo  CI  lb  o 

d  1— I  T-l  Cl 


CO  05  CO  1^  lO 
lO  CI  CI 
lO  CO  CO  GO  lO 


1^  03  lO  CO 
CD  1—1  O  CD 
lO  CD  lO  lO 

CO  CO  CI  o  lb 

-1  CI  1—1 


05  1— I  CI  O 

^  C^l  05  CO 

.— I  CO  O  CO  1 — I 


1—1  CO  GO 
CI  CO  CI  CO 

CI  1—1  CO  lb 


-tH  CO  1— I  lO  lO 

lO  O  lO  CX)  ryH 

i^-  O  CO  03 

CI  I— I  CI 


— H  05  CO  1 — ^  05 
CI  CO  lO  CO  lO 
■^10  0  03  05 


1— I  CT  CO  CO  00 
GO         CO  CO  lO 

CO  CO  CI  lO 
CI  CI  1—1 


cog 


ICS  O  CO  05  ^ 

lO  CI  00  05  o 

-TiH  O  cX)  CI  CO 

O  03  1— I  CI  CI 

I— f  1— I  1 — ^  CI  CO 


-t<  d  CO  t~  1— I 
lO  CI  lO  CI  1 — I 
r-l  00  GO  CO  CO 

CO  1— I  cb  CO 
1—1  CI  CI  1—1  CI 


CO  CD  lO  O 
CI  lO  GO 

CI  CO  CO  ^  in 

CD  lb  CD  i.^ 
r-1  O  CI  CI  1— I 


lO  CO  05  T— i  CO 
O  .— I.-*  CO  t~ 
OO  1 — ^  1— I  ^  CO 

o  CI  Ai  CI  CI 

CI  CT  r-H  CO  CO 


1^  CO  05  O  1— I 
CI  CO  CO  03  CD 

CO  in  00  CO 


o 


05  t~  I:^  CD  CI 

O  CO  00  00  o 
do  lb  GO  00  o 

1 — I        1—1  CO 


CD  1— I  1— I  ^ 

CI  o  ^  in  CD 

CD  OO  t--  4t<  CO 
1 — ^  1 — I  1 — I  1 — ^  CI 


O  O  00  C3 
GO  CI  I— I  ^  ---H 
CO  ^  ^  OO 
1— I  CI  CI  C5  1— < 


^  in  CD  CI  CI 

1— -I  O  O  r-l  CT 

1^-  05  CO  05  O 
1—1  1—1        CI  CO 


m  03  m  t~  lo 
CO  lo  CO  00  m 
^  in  CO  CO  CO 

CI  CO  1 — ^  1 — 1 


CI  1^  CI  CO 
CI  O  O  CO  CO 

CO  O  r-H  CI  CO 
1 — ^  1— I  O  ^  05 

CO  in  CO  m  CO 


CO  CO  1—1  —H  CI 
O  00  CI  ^  1—1 
^  CO  t;-  O  p 

rA  cji  CO  CI  CI 

CD  in  lo  in  CI 


CO  O  CI  CD  — 1< 

O  CI  CI  CTi 

GO  1 — ^  ^  1 — ^  03 

r— I  ff-l  CO  1— I 

I— (  in  CO  i-^ 


1— I  I>-  O  ^  CO 
O  ^  CO  o 
1 — ^  O  03  05  in 

1— I  CO  CO  O 

in  m  CO  CO 


mi — ^  o  1 — I  o 

O  O  GO  CO  OO 
CO  05  CO  1 — ^  CO 

tA  CO  lb  lb  --t< 
in  m 


Pi 


in  ^  CD  CO  CO 

in  t;-  r-l  -rt<  05 

CO"         CO  d  1— I 

in  ^  in  in 


o  in  00  m  00 
o  o 

J^-  I~-  CT  CD  CO 

in  in  m  in  CI 


03  05  03 

r-H  CO  CO  CO  p 

CO  1:--  r^  CO 

1— I  'ti  in  CO  1— I 


-H  O  O  in  o 

^       T'  T' 

do  CI  CO  cb 
-th  m  m  CO 


Cl  CO  CD  O  00 
in  05  CD  00  05 

CI  03  in  in  CO 
m  in 


CO  O  CO  ^ 
CO        CO  1—1  CO 

^  00  05  m  1—1 


i  n  05  m  CO  CO 

CI  1—1  CI  I— ( 


in  CO  C75  M<  CO 

CO  05  03 

^  CO  CO  00  05 


o  -H     o  in 

CI  CO  CI  CI  o 

o      in  in  CI 


CO  CI  OO  1^  CI 
05  CO        CI  CO 
00  CD  CO  1— ( 


CO  -*  1— I  ^ 
-H  CO  CO  CI  CI 
CI        t-  CI  CO 


O  -tH  CT  t~  00 
CI  r— I  1 — ^  1 — I 


1— I  1^  CI  05  r— I 


t—  1— I  CO  O 
1— I  T— I  CI  1—1 


o  o  o  o  o 


in  cT  CI  in  Cl 
CO  Cl  m  00  m 

CO  O  CD  CO  C73 

CO  CO  CO  cq 


o  >— I  CO  in  o 
CO  cj  ^  cq  Cl 

CO  Cl  o  i>-  CO 

Cl  Cl  Cl  Cl  I— I 


CO          -*  05  <» 

1— I  in  -H 

Cl  ^  05  -4l  Cl 


C75  t~  -rt<  in  CO 

Cl  O  p  t- 

CO  do  CO 

Cl  1—1  CO  1—1  r— I 


1— I  in  CO  o  Cl 
o  CO  CO  in  CD 


m 
P 
P3 
< 

< 

Ph 


13 


P  S  S  ^  ft 


|l4  O 


2  M 

S  g 

<j  o 


n 
o 

h 

fx  - 
«2 


o 

Eh 

s  ^ 

S  S 

K  !z; 
Dos 
MOM 


i4 

HH  M 

tu  ft 

»  w 

<!  O 

>  !2! 

O  <J 


f  W  S  H 

02  d 


1— icico^in  coj:^cx)050 


Cl  CO  in 


CO  Xr~  00  c:5  o 
1 — I  1 — I  1 — ^  1 — I  Cl 


I— I  Cl  CO  in 

Cl  Cl  Cl  Cl  Cl 


63 


TABLE  XIV.— CENSUS,  1901— GLASGOW :  AVERAGE  NUMBER  OF  INMATES  PER  HOUSE  OF 
EACH  SIZE  AND  OF  ALL  SIZES,  ALSO  PERCENTAGE  >  OF  EMPTY  HOUSES  IN 
MUNICIPAL  WARDS. 


MUNICIPAL  WARDS. 

1 

Apart- 
ment. 

2 

Apart- 
ments. 

3 

Apart- 
ments. 

4 

Apart- 
ments. 

5 

Apart- 
ments 
and 
Upwards. 

All 
Sizes. 

Per- 
centage 

of 
Empty 
Houses. 

1 

DALMARNOOK,  - 

3-218 

5-266 

5-941 

5-765 

j 

7-298 

4-599 

4-5 

1 

2 

CALTON, 

3-019 

1-962 

5-746 

6-314 

7-754 

4-644 

5-4 

2 

3 

MILE-END,  - 

3-287 

5-232 

6-200 

6-227 

7-432 

4-628 

4-4 

3 

■4 

WHITEVALE, 

3-305 

4-935 

5-643 

5-902 

9-240 

4-773 

2-5 

4 

5 

DENNISTOUN, 

2-997 

4-346 

4-981 

5-332 

5-859 

4-629 

3-7 

5 

6 

SPRINGBUEN, 

3-459 

5-216 

6-206 

5-811 

5-885 

4-841 

6-3 

6 

7 

COWLAIRS,  - 

3-329 

5-210 

6-015 

6-267 

6-100 

4-964 

4-3 

7 

8 

TOWNHEAD, 

2-981 

4-881 

5-733 

6-135 

7-292 

4-795 

4-9 

8 

9 

BLACKFRIARS,  - 

3-164 

4-986 

5-871 

6-595 

9-311 

4-833 

4-8 

9 

10 

EXCHANGE,  - 

2-701 

4-571 

6-120 

5-600 

9-130 

5-499 

6-2 

10 

11 

BLYTHSWOOD,  - 

2-611 

3-971 

4-994 

5-000 

6-886 

5-448 

3-1 

11 

12 

BROOMIELAW,  - 

2-899 

4-916 

5-788 

6-780 

12-127 

5-310 

3-7 

12 

13 

ANDERSTON, 

3-036 

4-882 

5-733 

5-752 

6-375 

4-785 

2-6 

13 

14 

SANDYFORD, 

3-163 

4-754 

5-241 

5-596 

5-620 

4-848 

3-3 

14 

JrAKK,    -        -        -  - 

2-419 

4-237 

4-733 

4-707 

5-796 

4-979 

3-1 

15 

16 

COWCADDENS,  - 

3-1 GS 

5-005 

5-638 

6-237 

7-100 

4-760 

5-4 

16 

17 

WOODSIDE,  - 

3-051 

4-714 

5-389 

5-491 

5-807 

4-641 

4-0 

17 

18 

HUTOHESONTOWN, 

3-178 

5-115 

6-323 

7-077 

U  0\J\J 

■J:  'JOO 

-J  1 

i  o 

19 

GORBALS,  - 

2-954 

4-768 

5-495 

6-101 

6-785 

4-934 

3-8 

19 

20 

KINGSTON,  - 

3-214 

4-842 

5-221 

5-802 

6-570 

4-828 

2-6 

20 

21 

GOVANHILL, 

3-382 

4-517 

5-281 

5-073 

5-942 

4-624 

3-4 

21 

22 

LANGSIDE,  - 

2-622 

4-135 

4-083 

4-613 

5-580 

4-634 

7-1 

22 

23 

POLLOKSHIELDS, 

2-872 

4-964 

4-796 

4-414 

5-663 

5-222 

5-9 

23 

21 

KELVINSIDE, 

2  333 

4-6.30 

4-106 

4-443 

5-677 

5-230 

6-3 

24 

25 

MARYHILL,  - 

3-329 

4-792 

5-314 

4-702 

5-374 

4-714 

8-3 

25 

CITY  - 

3  183 

4-927 

5-409 

5-330 

6-054 

4-769 

4-5  1 

64 


■73 


^  ^  ^ 


^      ^  ft 


O 

O 


a; 

o 
H 


0) 
be 

ea 

o 


O 

o 


a 

o 
o 

pq 


o 

to 


-73 


02 


4<! 
Ph 


o 

O 

O 


'w 

O 

o 


ID 


O 

C5 


be 


> 

o 


bo 

a 

1-1 


■73 


o 
Ph 


o 


CO 


65 


< 
K 

o  ^ 
W 

<1 


M 

o 

Ph  o 
O  H 


Total. 

1  o 

CO 

1,591 

CI 

lO 

CO 

2,203 

1,033 

IC 

CO 

t: 

Total. 

1  lO 

1 

in 

CJ 

OS 

CO 

c:s 
CO 

Cl 

s 

1,321 

ARTMENTS. 

o 

03 

1 

CO 
■o 

CD 

CD 

o 

lO 

< 

o 

OS 

CI 

OS 

Cl 

03 

CO 

o 

o 

03 

1  ^ 

CO 

lO 

01 

cs 

»o 

"O 

IC 
CD 

CI 

a 

< 

rli 

Z; 
g 

o 
o 

cs 

CI 

CO 

OS 

in 

CD 

in 

05 
03 
00 

■* 

OS 

(M 
CO 

00 

CO 

CO 

CO 
OS 
CI 

OS 
cs 

CI 

OS 

ICI 

Os" 

cs 

00 

1  ^ 

CI 

CD 

CO 

ao 

05 
00 

1  ^ 

CO 

c^ 
'M 

CO 

CI 

CI 

00 

iC 
CI 

lO 
1  - 

CD 
lO 

CO 

00 
OS 
00 

d 

in 

'O 

Cl 

o 

Cl 

« 

O 

00 

cc 
I  - 
CI 

00 

OS 

CO 

uc 
CI 

o 

CI 

OS 

E-i 

Pi 
<. 

Pj 
< 

t-^ 

00 

OS 

in 

CO 

o 

CD 

00 

1  ^ 

1  ^ 

OS 

-(< 

o 
cs 

o 

cs 

CD 
-V 
CI 

IC 
CI 

CD 

t- 
1- 

CD 

OS 

CO 

CD 

00 

cs 

o 

USES 

lO 
05 

00 

lO 

CO 
1— ( 

CO 

CI 
CO 

o 
CO 

■* 

CO 

-* 
o 

CI 

3 

CI 

cs 

lO 
cs 

c» 

CI 

CO 

o 
in 

o 

00 

Ho 

-* 
OJ 

00 

CO 

«M 

cs 

CO 

■* 

iCt 
00 

CO 

00 
CI 

00 
o 

i  Tj< 

1 

o 

m 
H 

-*< 

OS 

CZ) 

CO 

CD 

CO 

00 
CD 

03 
03 
OO 

(M 

CO 

in 

00 
CO 

CI 

CI 
OS 
I  ^ 

U 

o 
td 

hH 

CO 
<3S 

00 

CI 

CO 

in 

CO 
Cl 

OS 

(N 
03 
00 

o 

■* 

o 
o 

«5 
CO 

CI 

o 

CO 

CI 

OS 

CO 
CI 

CD 

CI 

OS 

00 

00 

GO 

CI 

Cl 

00 

"cS 

o 
H 

OS 

OS 

lO 

CO 

o 
CO 

lo" 

CO 

OS 

1  - 

CI 

OS 

CO 
CO 

CO 

OS 

CD 

IC 
CO 

lO 

CO 
c£ 

"a 
o 
H 

CI 

00 

CO 

CO 

o 

CO 

CI 

.Q 
CS 

CO 

CN 
CO 

o 

o 

05 

CO 

OS 
CO 

00 

CO 
IC 

CI 

CO 

c^ 

-f 

CI 

o 
cs 

CI 

-* 

CI 

OS 

m 

in 

Cl 

Cl 

OS 

o 
o 

OS 

CO 

o 

CO 
CO 

o 

CO 

CO 

o 

CI 

o 
o 

OS 

CD 

Cl 
Cl 

o 

•SINS 

03 
03 
00 

lO 

CO 
CO 

CO 

00 

OS 

cs 

CO 

OS 

CI 

00 

IC 
CI 

GO 

to 
H 

z; 
S 

Eh 
P3 

Pi 

cs 

cs 

00 

00 

CI 

OS 

CO 

in 

CO 

.partm: 

CO 
03 
00 

CO 

CI 
CI 

CI 

CO 

CO 
t- 

o 

CI 

TfH 

ira 

CI 
t~ 

fi 

CO 
CO 

CO"  ; 

CO 
OS 
CO 

CD 

00 

CO 

CO 

o 

Cl 

Two  k 

CO 

OS 

OS 

lo 
o 

CO 

o 
1^ 

CO 

o 

lO 

CO 
lO 
CD 

1.C 
lO 
CI 

CO 
OS 
iCl 

in 

lO 

cf 

1-1 

t- 

OS 
GO 

r- 

rH 
Cl 

Houses  or 

CO 

o 

00 

CO 

lO 

cs 

~v 

cs 
CO 

CO 
o 

CI 
CI 

cs 

CO 

t  - 

o 

CD 

CO 

CI 

CO 

CO 

o 
as 

CO 
OS 

00 

-V 

in 

in 

OO 
CD 

lO 
cv 
00 

00 

C)  ■ 

o 

CO 

CO 

CO 

CI 
CO 

CO 

CI 

OS 

CO 

00 
CI 

CO 

CO 
CO 

O 

W 

lO 
cs 

00 

CI 

CO 

CI 

CO 
OO 

00 
Cl 

00 
CO 

■* 

03 

00 

CO 
CO 

OS 
CO 

CO 

CO 

CI 

OS 

CO 

CI 
CI 

CO 

CI 

CO 
CO 
CI 

OS 
lO 

OS 

00 

CO 

CI 

CO 

CO 

Cl 

in 

CS 

00 

CO 
03 

00 

(M 

CM 

tH 

CO 
CO 

CI 

lO 

CO 

lO 

o 

CO 

CD 
CI 

CO 

CO 

CO 
OS 

00 

CO 

1^ 

o 

Cl 
Cl 

CO 

OS 

1~ 

s5 

CI 

LO 

o 

OS 

CI 

in 

OS 

CO 

Cl 

Cl 

in 

Is 
o 

OJ 

o 

CO 

00 

CO 
OS 

o 

ao 

CO 
lO 
lO 

CO 
IQ 

OS 

lO 

CO 
CO 

in 

-*3 

o 
H 

CO 
IC 

CD 

in 

CO 
o 

CO 

CS 

CO 

CO 

CO 
Cl 

S 

00 

o 

C3 

OS 

CI 

CI 

00 

CO 

t-^ 
CO 

o 
OS 

CI 

00 



Cl 

m 

OS 

CO 

Cl 

g 
E-i 

o 
o 

OS 

CI 

CO 

>o 

CI 

CO 

CI 

o 

H 
P5 

o 
o 

OS 

<3 

CI 
CI 

00 
crs 

o 

o 

Cl 

OS 
OS 

OO 

OS 

CO 
CI 

?^ 

ira 

CO 

in 

00 

cs 
cs 

00 

CD 

CO 

OS 

Cl 

in 

■* 

00 

-r; 

00 

cs 

CO 

00 

CO 

CO 

c5 

CI 
CI 

00 
o 

00 

< 

< 

OO 

cs 
oc 

in 

CO 

CO 
CI 

lO 

CO 

CO 

in 

CO 

One 

OS 

CO 

OS 

00 

CO 

CI 

OS 

OO 
CI 

CI 

CO 

00 

P5 

& 
o 

Pq 

o 

OS 

00 

in 

CO 

CO 

CI 

00 

o 

O 
Cl 

o 
tfi 

CO 
OS 
CO 

Ol 

CO 

CI 

OS 

OS 
CI 

OS 

lO 

cs 

OS 

o 

CO 

CO 
CI 
LO 

CO 
<3S 
OO 

CO 

in 

CS 

CI 

00 

t  - 

CO 

o 

CO 

CO 

CO 

w 

■A 

c 

OS 

00 

^ 

OS 
CI 
CI 

cs 

lO 

1^ 

CO 

?1 
CD 

m 
Ed 

CO 

lO 
OS 
OO 

d 

CO 

o 
o 

Cl 

^ 

OS 
00 

CO 
CO 

(M 

"O 

00 

CO 

t- 

CO 
>o 

lO 

CO 

o 

O 

w 

^ 

cs 

OO 

o 

Cl 

Cl 
CO 

GO 

in 

CD 

Cl 

CO 

OS 

CO 
CO 

CO 
OS 

OO 

lO 

CO 
CI 

50 

CO 

CI 

ICS 

CO 

CO 

CO 
OS 

00 

t- 

in 

in 

CO 

CO 
Cl 

cs 

Cl 

m 

CI 

cs 
00 

CO 

CO 

CI 

o 

1— ( 

CO 
CI 

OS 

o 

CO 

CI 

CI 

OS 

00 

in 

CI 

CO 

CI 

-H 
CI 

CO 

Cl 

CO 

1^ 

Cl 

Police 

X/Ik3  UI       L  . 

<1 

PQ 

o 

ft 

tq 

w 

< 

m 

O 

O 

H 

O 

w 

/ 

CORPORATION   OF  GLASGOW. 


ySMALLPOX,  1900-1902. 


REPORT 

BY 

A.  K.   CHALMERS,  M.D., 

MEDICAL   OFFICER   OF  HEALTH. 


GLASGOW  : 

PRINTED   BY   ROBERT   ANDERSON,    142   WEST    NILE  STREET. 


CONTENTS. 


Page 


I.  General  Outline  of  Outbreak — 

Pre-epidemic  Period,        ...        ...        ...        ...        ...        ...  ...  9 

Epidemic  Period,  ...        ...        ...        ...        ...        ...        ...  ...  15 

Recrudescence,      ...        ...        ...        ...        ...        ...        ...  ...  19 

II.  District  Distribution — 

Question  of  Hospital  Influence,   ...        ...        ...        ...        ...  ...  23 

Attack-rate  in  Districts  presenting  high  general  Death-rates,  ...  ...  30 

III.  Age  Incidence — 

Infantile  Vaccination,      ...        ...        ...        ...        ...        „.  ...  33 

Mortality  in  Vaccinated,  XJnvaccinated,  and  Doubtfully  Vaccinated 

Persons  at  several  Age  Periods,      ...        ...        ...        ...  ...  36 

The  Age  Incidence  of  Deaths  in  1855-7,  1870-2,  and  1900-1  compared,  37 

IV.  Re-vaccination — 

In  Relation  to  Attacks  occurring  within  14  days,        ...        ...  ...  44 

In  Persons  Re-vaccinated  in  former  years,         ...        ...        ...  ...  45 

The  Re-vaccinated  Portion  of  the  Population,    ...        ...        ...  ...  46 

Cost  of  Re-vaccination,     ...        ...        ...        ...        ...        ....  ...  47 

Appendices— 

Tables  of  Meteorological  Observations  at  Glasgow  Observatory,  ...  51-58 


Daily  Chart  of  Sickenings  during  Epidemic  Period. 
Do.        DURING  Recrudescence. 

Maps  Showing  Distribution  of  Cases — 

I.  Registered  in  several  fortnights  ending  2nd  June,  1900. 
II.  Sickening  in  several  fortnights  ending  30th  June,  1900. 

III.  Do.       in  several  fortnights  ending  12th  January,  1901. 

IV.  Registered  in  fortnight  ending  2Gth  January,  1901. 
V.        Do.       in  fortnight  ending  9th  March,  1901. 

VI.  Occurring  during  Recrudescence. 
VII.  Occurring   in   Eastern  District  during  fortnight  ending  22nd 
February,  1902. 


PROGRESS   OF  OUTBREAK. 


General  Outline. 

The  course  of  the  Smallpox  prevalence  which  began  in  April,  1900,  has,  up 
till  the  date  of  reporting,  presented,  in  a  general  way,  three  phases — a  pre-epidemic 
period ;  one  of  epidemic  severity  within  a  comparatively  limited  area ;  and,  after  an 
interval  of  four  months,  a  period  of  recrudescence. 

The  pre-epidemic  period  may  be  said  to  have  lasted  from  the  introduction  of 
the  disease  in  April,  1900,  until  the  following  December.  The  epidemic  attained 
its  maximum  prevalence  between  January  and  March,  1901,  after  which  the 
number  of  attacks  rapidly  declined,  and  the  last  sickening  in  this  phase  of  the 
outbreak  occurred  on  29th  June.  It  reappeared  early  in  the  following  November, 
and  again  displayed  considerable  vigour  during  the  spring  months  of  the  present 
year. 

The  separation  of  these  periods  is  fairly  definite,  although,  even  in  the  early 
weeks  of  the  pre-epidemic  stage,  there  was  already  evidence  of  widespread  activity, 
and  in  the  middle  of  the  epidemic  period  an  interval  of  decreasing  prevalence 
occurred,  which  extended  from  1st  to  ISth  February,  and  separated  the  periods  of 
maximum  sickening,  which  had  occurred  on  17th  January  and  again  on  1st 
February,  from  a  period  of  more  sustained  prevalence,  beginning  on  19th  February 
and  ending  on  2nd  March. 

The  disease  was  introduced,  under  circumstances  to  be  afterwards  described, 
into  an  overcrowded  one-apartment  house  in  District  No.  11  (Calton),  which 
forms  part  of  the  eastern  limit  of  the  Central  Sanitary  District.*  Ten  or  twelve 
days  elapsed  before  medical  attendance  was  sought  and  the  nature  of  the  disease 
recognised,  with  the  result  that  in  this  and  the  next  following  fortnightly  period 
cases  occurred  in  eight  households  in  the  same  tenement,  and  in  others  elsewhere, 
in  persons,  some  of  whom  were  only  then  found  to  have  been  resident  in,  or  visitors 
to,  this  tenement  during  the  unrecognised  period  of  the  first  patient's  illness. 
During  the  first  fortnight  of  the  outbreak  (ending  21st  April)  all  the  cases 
registered  were  among  residents  in  the  tenement  in  question,  but  already  in  the 
second  fortnight  (ending  5th  May)  four  almost  simultaneous  attacks  occurred  in 
one  household  in  the  Eastern  (Preston  Street),  which  had  no  traceable  con- 
nection with  the  earlier  cases,  and  in  the  third  fortnight  (ending  19th  May)  cases 
were  recorded  in  all  the  districts  save  the  South-Suburban  and  North-Western. 
In  this  last  fortnight  the  cases  numbered  21  in  all,  and  5  only  of  them  could 
be  associated  with  known  sources  of  infection.  In  the  fortnight  which  ended 
2nd  June  the  new  cases  registered  had  a  similar  distribution,  with  the  inclusion, 
however,  of  two  from  the  South-Suburban  area.  The  North-Western  remained  free 
from  the  disease  till  the  closing  fortnight  of  the  year,  when  one  case  was  registered. 

*  For  statistical  purposes  the  whole  area  of  the  City  is  divided  iuto  34  Districts,  which,  for 
purposes  of  administration,  again  are  combined  in  7  Groups,  known  also  as  Districts,  and,  for 
convenience,  referred  to  as  East,  Central,  Northern,  Southern,  Western,  South-Suburban,  and 
North-Western. 


6 


So  far,  a  large  proportion  of  the  cases  had  occurred  in  the  Central  District, 
in  which  the  disease  began,  and  until  the  close  of  the  fortnight  ending  2nd  June, 
of  the  72  cases  which  had  been  registered,  33  were  from  the  Central  and  18 
from  the  Eastern  Districts  of  the  City.  In  the  following  weeks  a  change  in  the  dis- 
tribution occurred,  accompanied  by  evidence  of  increased  activity  in  the  propagation 
of  the  disease.  During  the  fortnight  ending  16th  June  40  new  cases  were  registered, 
27  of  which  were  in  the  Eastern  District ;  and  in  the  fortnight  ending  30th  June  this 
district  contributed  34  of  the  58  cases  then  recorded.  This  exaggerated  incidence 
in  the  Eastern  District  continued  to  characterise  almost  all  the  subsequent 
fortnights  until  the  disease  disappeared  in  the  following  summer,  and  it  again 
became  a  feature  in  the  development  of  the  I'ecrudescence  in  the  spring  of  1902. 
Although  most  of  the  other  divisions  in  turn  developed  definite,  and  sometimes 
repeated  foci  of  infection,  there  occurred  in  none  of  them  any  prevalence  at  all 
equal  to  that  presented  by  the  Eastern. 

In  the  late  summer  and  autumn  of  1900  the  disease  abated,  but  late  in 
November  an  increase  began,  which  finally  reached  its  maximum  intensity  in  the 
week  ending  19th  January,  1901,  when  255  new  cases  occurred. 

In  the  following  week  the  new  cases  fell  to  93,  but  again  in  that  ending  2nd 
February  111  sickened.  The  next  fortnight  was  characterised  by  diminishing 
prevalence,  89  cases  being  recorded  in  the  first  and  62  in  the  second  week ;  and  the 
absence  in  this  latter  week  of  an  increase,  which  might  be  assumed  to  have  an 
incubation  period  in  definite  time-relationship  with  those  which  had  occurred  in  the 
week  ending  2nd  February,  appeared  to  indicate  a  moderation  in  the  intensity  of 
the  outbreak.  In  the  three  weeks  which  followed,  however  (23rd  February, 
2nd  and  9th  March),  100,  172,  and  107  new  sickenings  occurred.  In  two  periods, 
therefore,  each  of  three  weeks'  duration,  and  separated  by  an  interval  of  two  weeks 
459  and  379  cases  occurred;  but  whereas  in  the  first  period  there  was  a  markedly 
diminished  prevalence  in  the  middle  week,  the  prevalence  during  the  last  three 
weeks  was  maintained  throughout.     To  this  circumstance  we  shall  return. 

In  the  period  of  recrudescence  the  distribution  followed  the  main  lines  of  the 
pre-epidemic  and  epidemic  prevalence. 

It  will  be  convenient  here  to  tabulate  the  number  of  cases  registered  in  the 
several  Sanitary  Districts  in  the  successive  fortnights  of  each  of  the  three  periods 
just  referred  to,  and  the  accompanying  maps  should  be  referred  to  for  information 
regarding  the  general  arrangement  of  the  districts.  The  figures  given  in  the 
Tables  here  referred  to  include  all  admissions,  and  consequently  contain  some  (27 
in  all)  in  which  the  subsequent  development  of  symptoms  warranted  the  exclusion 
of  smallpox,  although  the  records  of  the  individual  fortnights  had  been  closed 
before  the  necessary  corrections  could  be  made.  For  this  reason  the  numbers  here 
given  are  in  excess  of  the  revised  figures  to  be  subsequently  dealt  with  : — 


7 


Table  I.— Pre-epidemic  Period,  April — December,  1900. — Cases  reported  in  the 

SEVERAL  FORTNGHTS. 


Fortnight  ending 

Central. 

East. 

North. 

South. 

West. 

S.-S. 

N.-W. 

Whole 
City. 

No.  ill 
Hospital. 

21st  April, 

9 



9 

8 

5th  May,  - 

6 

7 

13 

20 

19th    „  - 

7 

2 

9 

2 

1 

21 

27 

2nd  June, 

11 

9 

5 

1 

1 

2 

29 

40 

16th  „ 

4 

27 

2 

7 

40 

61 

30th  „ 

10 

34 

7 

5 

1 

1 

58 

93 

14th  July, 

2 

9 

1 

1 

13 

68 

28th  „ 

5 

18 

o 

25 

49 

1 1th  August, 

•) 

18 

1 

1 

1 

23 

55 

25th 

3 

3 

29 

8th  September, 

2 

11 

2 

15 

30 

22nd 

1 

6 

3 

11 

23 

6th  October, 

2 

9 

11 

26 

*20th 

o 

4 

1 

11 

1 

19 

36 

3rd  November, 

2 

2 

3 

1 

8 

■  25 

17th 

1 

4 

1 

6 

22 

1st  December,  - 

17 

1 

3 

21 

33 

]  5th  „ 

9 

18 

1 

8 

36 

58 

29th 

8 

18 

3 

5 

1 

1 

1 

36 

75 

Total, 

83 

216 

26 

41 

23 

7    1  1 

397 

*  Nine  of  the  cases  in  the  Southern  District  here  were  employees  in  a  wire  factory  in  the  district, 
and  1  in  the  Central  was  a  trade  canvasser,  whose  occupation  led  hira  to  visit  the  works  daily. 


8 


Table  II. — Epidemic  Period. — Cases  reported  in  several  Fortnights,  1901. 


Fortnight  ending 

C6iitrcil. 

East 

North. 

South, 

West. 

o.  -o. 

"NT  W 

±\  .-  V  V  . 

Whole 
City. 

No.  in 
Hospital. 

12th  January,  - 

6 

15 

1 

1 

23 

63 

26th 

14 

256 

6 

53 

2 

17 

2 

350 

377 

9th  February,  - 

20 

104 

22 

37 

4 

14 

1 

202 

436 

23rd  „ 

20 

67 

11 

17 

2 

7 

3 

127 

368 

9th  March, 

30 

219 

18 

26 

2 

3 

1 

299 

435 

23rd  „ 

16 

109 

12 

16 

4 

3 

1 

161 

373 

6th  April, 

15 

35 

16 

11 

10 

3 

2 

92 

234 

20th  „ 

10 

28 

8 

19 

2 

67 

155 

4th  May, 

3 

10 

6 

7 

1 

1 

28 

102 

18th  „ 

2 

12 

3 

1 

18 

55 

1st  June, 

3 

5 

3 

11 

35 

15th  ,, 

2 

2 

15 

29th  „ 

1 

1 

6 

8 

11 

13th  July, 

1 

1 

3 

Total,  - 

139 

863 

100 

200 

29 

48 

10 

1,389 

Table  III. — Recrudescence,  1901-2. — Cases  reported  in  the  several  Fortnights. 

Fortnight  ending 

Central. 

East. 

North. 

South. 

West. 

S.-S. 

N.-W. 

Total. 

No.  in 
Hospital. 

16  th  November, 

1 

1 

1 

30th 

5 

5 

6 

14th  December, 

3 

1 

4 

7 

28th 

7 

1 1  th  January,  - 

2 

1 

24 

1 

28 

33 

25th 

4 

3 

13 

2 

1 

23 

55 

8th  February,  - 

3 

4 

13 

3 

23 

50 

22nd 

12 

102 

14 

7 

3 

2 

7 

147 

169 

8th  March, 

13 

39 

12 

11 

13 

1 

3 

92 

202 

22nd  „ 

6 

32 

14 

25 

1 

3 

4 

85 

104 

5  th  April, 

5 

15 

2 

11 

2 

1 

36 

105 

19th  „ 

3 

6 

2 

1 

2 

1 

15 

71 

3rd  May, 

3 

4 

2 

1 

10 

37 

Total, 

48 

205 

103 

65 

24 

9 

15 

469 

9 


Conditions  influencing  Early  Spread  of  Infection. 

The  circumstances  under  which  the  first  case  occurred  were  exceptionally 
fitted  for  the  dissemination  of  infection,  and,  as  we  have  seen,  cases  were  occurring 
before  the  end  of  April  which  were  not  traceably  related  to  any  known  source. 

This  experience  was  frequently  repeated,  and  independent  foci  of  infection 
were  established  before  the  summer  of  1900  had  well  advanced.  Associated  cases 
not  infrequently  occurred — grouped  at  one  time  in  the  neighbourhood  of  the 
residence,  at  another  among  the  fellow- employees  of  some  one  whose  illness 
had  escaped  recognition  at  the  time  of  its  occurrence.  Mildness  in  type  of 
the  original  attack  not  infrequently  explained  these  groupings,  the  first 
illness  being  sometimes  regarded  as  Chickenpox,  or  as  a  "  bilious  "  affection,  while 
in  others  it  had  not  come  under  observation  at  all  until  the  secondary  attacks 
developed ;  but  evidence  of  communication  between  the  groups  was  not  always, 
or  indeed  often,  forthcoming,  especially  after  the  first  weeks  had  passed. 

It  has  already  been  indicated  that  the  disease  was  unequally  distributed 
throughout  the  City,  and  it  will  be  well  to  indicate  some  details  of  its  dissemination 
during  the  pre -epidemic  period,  so  that  we  may  be  better  able  to  consider  whether 
new  forces  came  into  operation  to  determine  its  epidemic  23revalence  at  a  later 
period,  and,  if  so,  what  they  were. 

Pre-epidemic  Period. 

Until  the  end  of  June,  1900,  the  numbers  sickening  increased  steadily,  but 
ga\e  way  during  the  autumn  months,  which  were  characterised  rather  by  a  per- 
sistent recurrence  of  the  disease  than  by  the  actual  numbers  sickening.  Chiefly, 
however,  in  the  early  period  of  increasing  prevalence,  a  notable  alteration  in  the 
■distribution  of  the  cases  occurred,  so  that  the  districts  invaded  between  April  and 
the  end  of  Ma}^  may  be  contrasted  with  those  invaded  in  subsequent  weeks.  For 
this  purpose,  on  Map  I.  the  localities  in  which  cases  were  recorded  in  each  of  the 
fortnights  ending  21st  April,  5th  May,  19th  May,  and  2nd  June  are  distinctively 
marked  in  black,  blue,  and  green  dots  respectively,  and  such  details  of  their 
association  with  each  other  as  were  at  the  time  discoverable,  and  are  now  necessary 
to  enable  their  distribution  to  be  followed,  are  transcribed  from  the  reports  of  the 
several  fortnights. 

The  invasion  is  thus  described  in  the  report  to  the  Health  Committee  for  the 
fortnight  ending  21st  April,  1900:— 

For  the  first  time  since  tlie  early  winter  of  1897,*  indigenous  cases  of  Smallpox 
have  occurred,  and  the  attendant  circumstances  create  some  apprehension  as  to  the 
future  spread  of  the  disease.  On  10th  April  I  was  asked  to  see  a  case  of  ilhiess  by 
the  medical  attendant  of  a  man  residing  at  3  Tobago  Street,  and  on  visiting  I  found 
him  suffering  from  Confluent  Smallpox,  the  symptoms  indicating  that  his  attack  was 
well  advanced  towards  the  end  of  the  second  week.  He  had  not  been  brought  under 
medical  observation  until  the  day  preceding  my  visit. 

The  man  had  been  a  seaman  on  board  the  s.s.  Hispania,  which  arrived  in  Glasgow 
on  18th  March,  from  Bombay  via  Liverpool.    I  had  been  advised  by  the  Medical  Officer 


*  On  5th  June,  1899,  there  was  admitted  to  Hospital,  suffering  from  Smallpox,  a  patient  from 
the  Northern  District  of  the  City,  who  had  arrived  in  Glasgow  on  23rd  May  from  India,  coming  over- 
land from  Marseilles,  at  which  port  he  arrived  on  20th  ultimo.  His  sickness  began  on  1st  June, 
which  would  coincide  with  exposure  to  infection  about  the  time  of  his  arrival  at  Marseilles.  There 
was  no  recognised  case  of  Smallpox  among  the  passengers  or  crew  of  the  steamer  in  which  he  came 
from  India. 


10 


of  Liverpool  of  the  occurrence  of  Smallpox  on  board  this  vessel  while  at  that  port,  and,, 
in  consequence,  had  the  crew  kept  under  observation  during  the  time  she  lay  in  port 
here,  i.e.,  from  18th  to  21st  March.  This  patient  was  re-vaccinated*  at  Livei-pool  with 
the  rest  of  the  crew,  and  it  had  been  reported  to  me  that  this  had  been  successful,  and 
that  the  patient  had  sailed  with  the  ship  on  the  21st.  Such,  indeed,  seems  to  have 
been  his  intention,  as  he  had  signed  articles  for  the  outgoing  voyage,  but  had  failed 
to  join  the  ship,  and  his  illness  began  towards  the  end  of  March.  After  his  death  no- 
evidence  of  re-vaccination  could  be  discovered. 

It  is  a  considerable  time  since  any  tenement  in  Glasgow  has  been  exposed  to 
such  concentrated  and  continued  infection  as  has  occurred  here,  and  the  events  which 
follow  are  of  more  than  usual  interest.  Up  till  the  present  time  (23rd  April)  eleven 
sicknesses  have  been  discovei'ed  as  the  result  of  this  man's  illness.  All  of  them,  except 
the  doctor  who  attended  him  and  a  pawnbroker's  assistant  who  received  articles  in 
pledge  from  his  household,  are  residents  on  the  same  stair  in  which  the  patient  lived. 
Three  of  the  cases  occurred  in  the  first  patient's  household — the  two  others  being  his 
wife  and  a  female  lodger — that  is,  all  the  inmates  thereof.  Three  others  occuiTcd  in 
a  house  on  the  top  flat.  The  others — an  unvaccinated  child  (who  has  since  died)  and 
its  mother — were  visitors  to  the  first  patient's  house,  and  there  are  two  single  cases  in 
separate  households.  In  all,  five  households  have  been  invaded,  and  four  out  of  the 
five  have  been  occupied  in  excess  of  their  legal  number.  In  the  first  patient's,  for 
instance,  three  adults  were  found  in  one  apartment  ticketed  for  two,  while  two  other 
houses,  each  ticketed  for  two,  and  one  house  ticketed  for  two  and  a-half,  were  each 
occupied  by  three  adults  and  three  children.  Further  illustration  of  the  social  habits 
of  the  family  first  attacked  is  afforded  by  the  inclusion  of  the  pawnbroker's  assistant 
among  the  victims. 

Tobapfo  Street,  where  the  first  patient  resided,  is  in  Sub-District  No.  11,  and 
the  invaded  tenement  is  marked  on  Map  I.  with  a  circle  enclosing  a  black  dot. 

In  the  next  fortnight,  ending  5th  May,  six  of  the  recorded  cases  occurred  in 
the  Central  District,  and  all  were  traceably  associated  with  Tobago  Street,  although 
at  the  time  of  their  discovery  some  were  resident  elsewhere. 

In  the  Eastern  District  seven  cases  were  registered,  and  some  details  of  their 
association,  and  of  the  migratory  character  of  some  of  the  patients,  are  given  in  the 
subjoined  extract : — 

During  the  fortnight  ending  Saturday,  5th  May,  13  cases  of  Smallpox  were 
registered,  making  22  in  all  from  the  beginning  of  the  outbreak.  12  of  these  occurred 
in  the  first  week  of  the  fortnight,  and  1  in  the  second.  The  connection  of  two  of  these 
occurring  in  the  first  week  with  the  first  case  was  noted  in  the  report  for  last  fortnight, 
and  the  following  details  have  reference  to  the  remaining  11  registered  during  the 
present  one.  3  of  the  attacks  developing  in  the  first  week  involved  three  separate 
families  residing  at  3  Tobago  Street,  and  occurred  in  persons  under  obsei'vation,  while 
a  fourth,  nominally  a  tenant  at  this  address,  spent  occasional  nights  in  a  Common 
Lodging-house,  and  had  slept  in  one  on  the  night  preceding  his  discovery.  A  fifth  case 
was  discovered,  through  information  gleaned  from  neighbours,  in  the  person  of  a  girl 
residing  at  16  Kirk  Street,  Calton,  who  had  been  a  visitor  at  infected  houses  in  Tobago 
Street,  but  whose  name  had  not  been  communicated  at  the  time  when  the  earlier 
infections  were  discovered.  She  was  ten  days  ill  when  removed  to  Hospital.  The  sixth 
case  was  a  woman  who  presented  herself  at  the  Central  Dispensary  for  treatment.  She 
had  been  resident  at  3  Tobago  Street  during  part  of  the  illness  of  the  first  patient,  but 
had  left  before  the  natui-e  of  his  illness  was  recognised,  and  in  the  intei-val  had  changed 


*  Much  correspondence  resulted  from  this  statement,  and  considerable  use  has  been  made  of  it 
by  opponents  of  vaccination,  who  omit  to  notice  the  further  statement  in  the  report  that  no  evidence 
of  re-vaccination  was  discoverable  after  death.  Several  months  after  the  incident  was  thus  recorded 
the  ship  surgeon  of  the  Hispania  during  this  voyage  returned  to  Glasgow,  and  it  was  then  learned 
that  the  re-vaccination  referred  to  in  the  minute  had  been  performed,  but  unsuccessfully,  during 
the  voyage  from  India,  in  the  month  of  February  preceding,  because  of  the  occurrence  of  Smallpox 
on  board,  and  that  the  operation  had  not  been  repeated  on  the  occurrence  of  subsequent  cases. 


11 


her  abode — first  to  a  friend's  house  in  34  Kent  Street,  leaving  this  to  spend  three  or 
four  nights  (I7th  or  18th  to  21st  April)  in  the  Moncur  Street  Model  Lodging-house 
before  taking  a  room  at  139  Stockwell,  in  which  she  resided  wh^  her  illness  was 
brought  to  light.  Case  No.  7  occurred  at  69  Main  Street,  Bridgeton,  in  the  person  of 
a  rag-store  worker,  employed  along  with  two  residents  at  3  Tobago  Street,  one  of  these 
being  a  lodger  in  the  original  patient's  house,  and  now  also  in  Hospital  with  the  disease. 
The  remaining  four  cases  were  in  members  of  one  family  in  Preston  Street,  Bridgeton, 
whose  association  with  the  Tobago  Street  centre  cannot  be  directly  traced.  They 
furnish  the  only  exception  in  the  history  of  direct  association  with  3  Tobago  Street, 
but,  taken  together  with  the  incidents  just  recorded,  they  indicate  that  the  source  of 
infection  has  now  spread  beyond  the  original  centre,  and  the  keepers  of  Model  Lodging- 
houses  have  been  advised  to  be  on  the  outlook  for  the  disease  among  their  patrons. 

It  is  to  be  observed  here  that  as  early  as  the  second  fortnight  evidence  that 
the  sources  of  infection  were  being  widely  distributed  was  supplied  by  the  Dis- 
pensary patient,  the  rag-store  worker,  and  the  frequenter  of  the  Common  Lodging- 
house ;  while  the  illnesses  in  the  Preston  Street  family,  which  began  with  the 
sickening  of  the  mother  on  the  20th  of  April,  after  a  period  of  confinement  to  the 
house  for  at  least  four  weeks,  brought  her  probable  date  of  exposure  to  infection 
back  to  within  a  day  or  so  of  the  time  (10th  April)  when  the  first  case  was 
recognised. 

The  following  fortnights,  ending  19th  May  and  2nd  June,  showed  an  extension 
of  the  disease  into  the  North,  South,  West,  and  South-Suburban  areas ;  and  as  this 
latter  fortnight  brought  one  phase  of  the  outbreak  to  a  close,  the  details  may  be 
followed  in  the  report  of  the  period. 

(Extract  from  Report  for  Fortnight  ending  19th  May.) 

During  the  first  week  of  the  present  fortnight  9,  and  in  the  second  week  12  persons 
were  admitted  to  Hospital  suffering  from  Smallpox.  This  is  an  increase  of  8  on  the 
number  registered  during  the  previous  fortnight,  and  while  5  of  the  cases  occurring 
within  the  first  week  were  in  persons  under  observation  in  consequence  of  their  associa- 
tion with  one  or  other  of  the  cases  referred  to  in  last  report,  none  of  those  occurring 
during  the  second  week  belong  to  this  category.  Of  these  latter,  however,  one  was 
supplied  by  a  woman  residing  in  Gallowgate,  who  had  attended  the  Central  Dispensary 
along  with  the  patient  noted  in  last  report,  and  whose  name  we  were  in  possesion  of, 
but  whose  address  could  not  be  ascertained,  while  another  case  arose  in  direct  association 
with  this  one. 

Of  the  cases  not  thus  accounted  for,  2  occurred  in  the  Eastern,  9  in  the  Northern, 
1  in  the  Central,  and  1  in  the  Western  District  of  the  City — a  sufficient  indication  that 
the  sources  of  infection  have  now,  as  was  anticipated  from  the  facts  which  came  to 
light  in  connection  with  the  cases  occurring  during  the  previous  fortnight,  extended 
beyond  the  limits  of  the  originally  infected  area.  This  is  specially  evident  from  the 
distribution  of  the  disease  in  the  Northern  District  of  the  City.  The  earlier  cases 
occurring  therein  suggested  contact  during  the  hours  of  employment  with  some  unrecog- 
nised case,  and  this  impression  was  strengthened  by  the  knowledge  that  several  fellow- 
workmen  had  their  residence  in  the  neighbourhood  originally  infected;  but  the  later 
cases  had  no  such  association,  although  the  dates  of  sickening  in  all  of  them  coincided 
with  exposure  to  infection  in  the  latter  half  of  April.  Indeed,  the  details  of  one  of  those 
later  cases  may  be  cited,  because  they  illustrate  the  risks  of  infection  to  which  the 
public  are  presently  exposed,  as  well  as  the  difficulty  which  attends  the  effort  to  bring 
particular  attacks  into  direct  connection  with  earlier  cases.  The  patient  in  question 
is  in  the  service  of  the  Corporation  as  an  attendant  at  one  of  the  places  of  popular 
resort  much  patronised  during  the  inteiwals  of  labour.  He  sickened  on  7th  May,  but 
was  able  to  attend  to  his  duties  till  the  evening  of  the  12th,  by  which  time  the  eruption 
was  at  least  two  days  old.    As  this  latter  date  was  a  Saturday  eftemoon,  quite  an 


12 


indiscriminate  exposure  to  infection  must  have  occurred  to  a  large  number  of  persons, 
the  result  of  which  there  is  presently  no  means  of  estimating ;  but  the  incident  will  lend 
emphasis  to  the  recommendation  that,  in  the  present  distribution  of  the  disease  among 
the  community,  successful  re-yaccination  should  be  accepted  as  the  only  efficient  means 
of  acquiring  protection  from  accidental  exposure  to  infection. 

Again,  in  the  fortnight  ending  2nd  June,  it  is  noted — 

In  the  North-Western  District  alone  has  no  case  hitherto  occurred.  As  in  past 
outbreaks,  we  are  again  finding  that  one  of  the  greatest  obstacles  to  efEectively  coping 
with  the  disease  is  the  occurrence  of  an  extremely  mild  and  modified  form,  which 
escapes  recognition  until,  as  a  result,  secondary  cases  of  a  graver  nature  arise.  The 
history  of  these  milder  cases  is  strikingly  uniform,  and  it  may  help  towards  a  recognition 
of  this  form  of  the  disease  to  briefly  outline  it  here.  In  the  majority  of  such  cases 
medical  advice  is  not  sought;  indeed,  there  may  be  said  to  be  no  definite  illness — 
merely  indisposition  for  a  day  or  two,  some  little  derangement  of  appetite,  and  then 
a  few  spots,  of  the  appearance  of  pimples,  on  the  face,  body,  or  limbs.  With  the 
appearance  of  these  spots  the  symptoms  of  indisposition  pass  off,  and  the  patient  is 
confirmed  in  his  impression  that  the  attack  is  a  "  bilious  "  one.  Tlie  subsequent  history 
of  an  example  of  this  may  be  related  at  length,  in  the  order  in  which  the  events  came 
to  knowledge.  An  employee  of  the  Lighting  Department  was  removed  to  Hospital 
with  a  well-marked  and  severe  attack  of  the  disease.  During  the  investigation  it  was 
ascertained  that  a  fellow-employee  working  at  the  same  desk  had  suffered  from  a  pimply 
eruption  of  the  character  already  indicated,  but  was  absent  from  work  in  consequence 
thereof  only  a  day  and  a-half.  On  examining  this  latter  a  few  stains  only  were  found, 
two  at  least  of  which  created  an  impression  that  they  had  been  produced  by  Smallpox. 
By  way  of  testing  this  impression  he  was  re-vaccinated  (unsuccessfully,  as  was  after- 
wards found),  and  instructions  were  given  to  disinfect  his  house.  On  proceeding  to 
carry  out  this,  however,  his  wife  was  found  actively  employed  in  domestic  duties  with 
a  quite  recognisable,  but  very  much  modified,  eruption  of  Smallpox,  about  three  days 
old. 

Of  a  diflierent,  but  equally  suggestive,  character  is  the  association  of  seven  cases 
occurring  near  the  junction  of  High  Street  and  Duke  Street.  Proximity  in  residence 
here  led  to  a  comparison  of  dates  of  sickening,  and  these  coincided  so  closely  that  a 
common  source  of  infection  was  suggested.  The  information  obtained  pointed  to  a 
common  acquaintanceship  of  the  patients  with  the  household  of  an  eating-house  keeper 
in  the  neighbourhood,  whose  wife,  it  was  then  learned,  had  died  after  some  short-lived 
symptoms  of  acute  illness  on  the  night  of  13th  or  early  morning  of  14th  May.  She 
had  been  a  chronic  sufferer  from  a  skin  eruption,  which  renders  obscure  the  description 
of  her  last  illness  as  told  by  friends,  and  there  was  no  medical  attendant.  Hsemon-hagic 
Smallpox,  however,  was  suggested  by  some  of  the  particulars  gathered,  but,  without 
being  able  now  to  verify  this  impression,  the  practical  value  of  the  incident  lies  in  the 
discovery  during  this  investigation  that  a  daughter  of  this  household  was  then  recover- 
ing from  an  attack  of  the  disease  so  mild  that  not  more  than  half-a-dozen  spots  could 
be  detected. 

One  case  admitted  during  the  fortnight  affords  quite  a  striking,  although  negative, 
illustration  of  the  protective  value  of  re-vaccination.  On  14th  May  a  patient  was 
removed  to  Hospital  from  a  tenement  in  the  Northern  District,  seven  days  ill  of  the 
disease,  and  on  the  same  day  each  household  in  the  tenement  was  advised  to  accept 
re-vaccination  of  its  adult  members.  All  the  tenants  had  this  operation  performed 
save  one  woman,  who  sickened  on  23rd  May,  and  is  now  in  Hospital  with  the  disease, 
her  husband,  who  was  re-vaccinated,  escaping. 

With  a  vivid  recollection  of  the  extensive  re-yaccination  carried  out  in  the  Model 
Lodging-houses  and  Prisons  in  quite  recent  years,  it  is  of  considerable  interest  to  note 
that,  although  up  till  the  present  three  Models  have  had  opportunities  of  "catching 
fire,"  so  to  speak,  from  the  occasional  residence  therein  of  persons  in  daily  intercourse 
with  houses  in  which  Smallpox  was  present  (in  one  case,  indeed,  a  patient  had  already 
slept  for  one  night  in  a  Model  with  the  eruption  upon  him),  nothing  has  as  yet  occurred 
to  indicate  their  successful  invasion. 


13 


With  regard  to  the  immediate  future,  everything  points  to  a  period  of  considerable 
anxiety.  It  cannot  be  too  strongly  impressed  on  the  community  that  our  present 
knowledge  of  the  distribution  of  the  disease  renders  it  a  question  of  simple  prudence 
for  each  to  protect  himself  from  risk  by  re-vaccination.  The  disease  is  no  longer  con- 
fined to  the  earlier  associates  of  the  neighbourhood  of  its  origin.  One  of  the  most 
recent  cases  occurred  in  Pollokshields  (District  25). 

We  have  now  reached  the  period  when  a  definite  invasion  of  the  Eastern 
District  occurred.  In  the  following  tabulation  the  district  distribution  of  all  the 
cases  recorded  in  three  successive  periods  ending  2nd,  16th,  and  30th  June 
(including  in  that  ending  2nd  June  all  the  cases  known  to  have  occurred  from  the 
beginning  of  the  outbreak)  are  given  : — 


Period  ending. 

Central. 

East. 

North. 

South. 

West. 

S.-S. 

N,.W. 

Total. 

2nd  June, 

33 

18 

14 

3 

2 

2 

72 

16th  „ 

4 

27 

2 

7 

40 

30th  „ 

10 

34 

7 

5 

1 

1 

58 

Of  the  9  cases  recorded  in  the  Eastern  District  till  the  end  of  the  fortnight 
ending  19th  May,  4,  as  has  been  said,  formed  a  detached  group  in  Preston  Street, 
and  3  others  could  be  referred  to  an  association  with  Tobago  Street.  Up  till  the 
occurrence  of  those  now  to  be  considered,  there  were  only  2  others  (in  the  fortnight 
ending  5th  May),  one  of  whom  (residing  in  William  Street,  Bridgeton)  had  a  similar 
association,  but  the  other  (residing  in  Montgomery  Streec)  was  untraced. 

It  will  lend  greater  precision  here  to  take  the  dates  of  sickening  in  preference 
to  the  period  of  notifications,  and  in  the  Map  II.  the  eastern  cases  only  which 
sickened  in  the  fortnights  ending  2nd,  16th,  and  30th  June  are  indicated,  by  black, 
blue,  and  green  dots  respectively.  In  the  several  fortnights  these  numbered  16, 
29,  and  22,  and  had  the  following  distribution : — -In  the  fortnight  ending  2nd  June 
a  grouping  occurs  round  Steven  Parade,  immediately  to  the  west  of  the  Hospital ; 
two  are  situated  in  the  neighbourhood  of  Dechmont  Street,  to  the  north ;  and 
several  are  more  widely  distributed,  especially  towards  the  lower  end  of  Springfield 
Road,  Baltic  Street,  and  Boden  Street.  In  the  fortnight  ending  16th  June  a  more 
definite  grouping  occurs  in  the  neighbourhood  of  Baltic  Street,  and  generally  in  a 
south-westerly  direction  from  the  Hospital ;  while  in  the  fortnight  ending  30th 
June  there  occurred  a  congeries  of  cases  round  a  tenement  in  London  Road,  under 
the  following  circumstances : — 

(Extract  from  lieport  for  Fortnight  ending  30th  June,  1900.) 

The  most  striking  incident  in  the  histoiy  of  the  disease  during  the  fortnight  was 
occasioned  through  the  notification  of  a  case  in  a  tenement  in  London  Road,  and  the 
subsequent  discovery,  as  a  result  of  house-to-house  visitation,  that  for  about  two  weeks 
the  disease  had  been  present  in  another  household  in  this  tenement,  and  that  several 
others  had  subsequently  been  invaded,  in  addition  to  the  one  in  which  the  notified 
case  occurred.  The  patient  whose  attack  stands  related  to  all  these  others  as  the 
source  from  which  their  infection  was  derived  was  a  girl  who,  when  discovered,  was 
in  an  advanced  stage  of  the  disease — progressing,  in  fact,  towards  recoverj^  but  still 
in  a  highly-infectious  condition.  Her  illness  had  been  a  moderately  severe  one,  as 
judged  by  the  crusting  present  on  discovery,  but  she  had  no  medical  attendance,  and 


14 


intercourse  between  the  members  of  her  household  and  the  community  was  unrestricted. 
Smallpox  infection  takes  full  advantage  of  the  opportunities  thus  offered  for  spreading, 
and  a  record  of  the  cases  presently  known  to  have  resulted  from  this  one  is  instructive. 
House-to-house  visitation  of  the  tenement  resulted  in  the  discovery  of  eleven  cases  in 
seven  households,  and  there  has  since  been  notified  or  discovered  a  neighbouring  shop- 
keeper doing  business  with  the  tenants  of  this  land;  a  fellow-worker  with  a  member  of 
the  originally  infected  household ;  three  visitors  to  the  tenement,  one  of  whom  resides 
in  the  Eastern  and  two  in  the  Northern  Districts  of  the  City — all  of  which  can  be 
relegated  to  infection  derived  from  this  source. 

In  addition  to  these  16  cases,  10  others  occurred  in  the  Eastern  District  who  were 
associated  with  each  other,  or  with  cases  in  the  previous  fortnight,  and  there  were  6 
others  for  whom  no  such  association  could  be  discovered. 

In  the  other  districts  of  the  City,  9  occurred  in  the  Central,  6  being  associated 
cases;  7  in  the  Northern  District,  only  1  of  which  had  no  traceable  association  with 
the  others ;  and  5  in  the  Southern,  4  of  which  had  a  traceable  coimection.  The  South- 
Suburban  District  and  the  Western  had  each  1  case.  In  all  58  cases  were  registered, 
against  40  for  the  previous  fortnight ;  but  it  may  be  observed,  as  affording  some  ground 
for  satisfaction,  that  the  majority  are  coming  under  notice  earlier  in  the  illness  than 
formerly,  and  the  chances  of  secondary  infections  from  them  are,  in  consequence,  con- 
siderably lessened. 


Occupational  Incidence. 

The  occupational  incidence  of  the  attacks  so  far  serves  only  to  indicate  the 
wide  distribution  of  the  disease  among  the  industrial  population,  without  presenting 
any  contrast  between  the  occupations  of  those  attacked  before  and  after  the 
beginning  of  June.  Prior  to  2nd  June  41  were  males  and  57  females.  During 
June  there  were  37  males  and  35  females. 

During  July  and  August  the  numbers  sickening  considerably  diminished; 
gradual  dissemination  through  unrecognised  mild  attacks  of  the  disease  took  place ; 
and  the  difficulty  of  stimulating  popular  interest  regarding  the  probable  nature  of 
illnesses,  however  mild,  when  accompanied  by  eruption,  was  again  proving  an 
obstacle  to  the  early  recognition  of  cases. 

An  enquiry  with  regard  to  the  probable  sources  of  infection  of  48  cases 
recorded  during  the  four  weeks  ending  11th  August  showed  that  in  14  cases  only 
could  this  be  ascertained  : — 


Fortnight, 

Fortnight, 

28th  July. 

11th  Augnst. 

5 

9 

Associated  with  previous  cases. 

13 

10 

Occurring  in  infected  neighbourhoods. 

7 

4 

No  definite  association  with  known  sources. 

Renewed  activity  began  towards  the  end  of  November.  In  the  fortnight 
ending  1st  December,  21  cases  had  been  reported,  and  in  each  of  these  ending 
15th  and  29th,  36  cases,  the  numbers  contributed  by  the  Eastern  Districts  being 
respectively  17  in  the  first  and  18  in  each  of  the  later  fortnights. 

In  Map  III.  the  distribution  of  the  cases  occurring  in  each  of  these  fort- 
nights is  distinctively  marked,  and  it  will  be  seen  that  while  those  occurring  in 
the  fortnight  ending  1st  December  are  widely  distributed  over  Districts  5,  7,  and  8, 
there  is  a  definite  grouping  in  the  next  fortnight  in  one  part  of  No.  5,  and  in 
the  second  fortnight  in  District  No.  7,  towards  Nuneaton  Street,  and  again  at  the 
foot  of  Springfield  Road. 

The  following  incident  in  connection  with  a  threatened  invasion  of  the  City 
Poorhouse  which  occurred  at  this  time  is  worthy  of  note  : — 


15 


City  Pooehouse. 

Early  in  December  two  cases  were  simultaneously  recognised  among  inmates  of 
the  City  Poorhouse,  one  of  whom  had  been  resident  from  the  previous  S_p.ptember, 
wliile  the  other  had  been  admitted  only  three  days  previously,  his  sickness  having  begun 
two  days  before  that.  They  were  in  separate  wards,  and  the  suspicion  created  by  the 
indigenous  case  that  infection  had  been  introduced  either  by  a  modified  and  not  recog- 
nised attack  or  through  visitors  was  confirmed  on  the  following  days  by  the  occurrence 
of  other  cases.  The  dates  of  sickening  were  as  follows: — 5th,  7th,  12th,  13th,  and  14th 
December;  while,  as  has  already  been  said,  another  inmate,  admitted  on  the  6th  of 
December,  had  already  sickened  on  the  4th. 

On  the  Poor  Law  Authorities  becoming  aware  of  the  gravity  of  the  outlook,  the 
services  of  the  whole  medical  stafE  were  called  into  requisition  for  the  purpose  of  re- 
vaccinating  both  inmates  and  applicants  for  relief,  and  it  was  subsequently  reported  to 
the  Health  Committee  that  in  the  City  Poorhouse  1,610  and  in  Barnhill  360  inmates, 
and  551  applicants,  had  been  re- vaccinated. 

The  result  of  this  vigorous  action  by  the  Poor  Law  Authorities  was  that  no 
subsequent  cases  occurred  among  the  inmates  until  the  following  winter,  when  the 
personnel  had  considerably  changed. 

* 

Epidemic  Period. 

By  this  time  we  had  reached  the  beginning  of  the  epidemic  period  of  the 
outbreak,  to  which  the  following  extracts  refer: — 

(Extract  from  Report  for  Fortnight  ending  12th  January,  1901.) 

During  the  fortnight  16  cases  of  Smallpox  occurred  in  the  Eastern  District,  6  in 
the  Central,  and  1  in  each  of  the  Southern  ,and  Western  Districts  —  a  total  of  24, 
against  36  in  the  preceding  fortnight.  Notwithstanding  this  reduction  in  the  number 
of  cases  registered,  the  outlook  is  not  reassuring,  and  the  approaching  months  are 
likely  to  see  a  still  further  extension  of  the  disease.  Among  the  causes  for  apprehension 
is  the  indifference  with  which  the  milder  forms  of  the  disease  are  being  regarded.  The 
following  is  an  illustration : — On  New- Year's  Day  a  case  of  suspected  Smallpox  was 
reported  from  Commerce  Street,  and  the  patient,  on  being  visited,  was  found  to  have 
been  only  a  fortnight  in  Glasgow,  and  for  the  most  of  that  time  to  have  lodged  with 
a  family  in  Argyle  Street,  where  he  had  sickened  on  28th  December,  and,  in  con- 
sequence, had  been  removed  to  a  friend's  house  in  Commerce  Street.  Coincident  with 
this  case  being  recognised,  a  telegram  was  received  from  the  Medical  Officer  of  Health, 
Aberdeen,  stating  that  a  case  of  the  disease  had  developed  there  in  the  person  of  a  man 
who  had  also  been  a  lodger  in  the  Argyle  Street  house,  but  had  gone  home  for  the 
holiday  season.  Enquiry  at  this  house  resulted  in  the  discovery  that  one  of  the  inmates, 
a  girl,  was  still  suffering  from  an  attack  of  much  modified  Smallpox,  but  had  recovered 
sufficiently  to  admit  of  her  returning  to  worlc,  in  a  tea-room  in  the  City,  for  the  last 
week  of  the  year.  It  was  further  found  that  a  younger  sister  liad  sickened  of  a  still 
milder  form  of  the  disease  a  fortnight  earlier — that  is,  in  the  end  of  November — so 
that  for  five  weeks  previous  to  the  New  Year  this  house  had  been  in  an  infectious 
condition,  while  the  inmates  were  pursuing  their  usual  avocations.  Neither  patient 
had  been  under  medical  treatment.  This  incident  occurred  in  a  house  of  six  apartments, 
inhabited  by  a  family  of  eight  persons,  in  addition  to  which  there  were  seven  lodgers, 
four  of  whom  were  still  in  residence,  and  tliree  had  either  removed  or  were  on  holiday 
— one  being  at  an  unknown  address  in  Morayshire  when  he  sickened  of  tlie  disease, 
but  returned  to  Glasgow  before  its  nature  was  recognised.  On  tlie  circumstances  being 
brought  to  the  notice  of  the  management  of  the  tea-room  in  question,  twenty-three  mem- 
bers of  the  staff  were  re-vaccinated,  and  the  period  of  incubation  has  now  passed  without 
any  sickening  among  them  having  occurred.  Seven  cases  in  all,  however,  arising  out  of 
direct  association  with  the  household,  have,  up  till  the  present,  been  discovered.  One 
of  these,  a  visitor,  residing  at  Great  Hamilton  Street,  afforded  an  excellent  illustration 


16 


of  how  a  mild  form  of  the  disease  may  give  rise  to  a  more  severe  form  in  a  person  not 
protected  by  vaccination.  The  patient  in  this  instance  had  visited  several  times 
during  the  currency  of  the  disease  at  Argyle  Street,  and  on  28th  December  sickened ; 
she  was  unvaccinated,  aud  her  attack  became  confluent.  . 

The  indifEerence  to  effective  re-vaccination  on  the  part  of  the  general  population 
is  much  to  be  regretted  in  the  present  position  of  Smallpox  in  the  City.  In  connection 
with  the  cases  reported  during  the  fortnight,  599  persons  were  re-vaccinated  in  the 
tenements  where  the  cases  occurred,  or  in  the  workplaces  in  which  they  were  employed, 
but  19  only  of  the  general  public  took  advantage  of  the  opportunity  of  free  vaccination 
offered  by  the  Health  Committee  through  medical  practitioners.  Smallpox  is  at 
present  widely  distributed,  and  the  temporary  inconvenience  which  re-vaccination  gives 
rise  to  is  a  trifling  consideration  to  place  against  the  absolute  protection  from  the 
disease  which  it  ensures.  District  visiting  and  the  work  of  the  various  philanthropic 
and  charitable  organisations  of  the  City  can  only  be  conducted  with  safety  at  the  present 
time  by  those  who  are  fully  protected  by  vaccination,  and  we  must  look  for  a  large 
extension  of  the  disease  in  our  midst  unless  voluntary  effort  is  made  by  every  section 
of  the  community  to  obtain  the  protection  which  re-vaccination  affords. 

[Extract  from  Report  for  Fortnight  endmg  26th  January,  1901.) 

During  the  fortnight  350  cases  of  Smallpox  were  registered,  and  the  resources  of 
the  administration  have  been  taxed  to  a  degree  quite  unknown  in  recent  years. 

In  the  Eastern  District  alone  256  of  these  cases  occurred;  in  the  South  and  South- 
Suburban  there  were  70;  in  the  Central,  14;  in  the  Northern,  6;  while  the  Western 
and  North- Western  Districts  have  each  2  cases. 

In  the  Eastern  District  the  majority  of  the  cases  have  occurred  in  certain  well- 
defined  groupings,  which  constitute  infected  areas  within  which  the  disease  has  assumed 
epidemic  vinilence,  and  in  the  Southern  District  a  similar  tendency  is  likewise  mani- 
fest, although  in  a  more  limited  form  at  present. 

The  areas  in  the  Eastern  District  in  which  this  has  occurred  are — 

(1)  Parkhead  generally,  but  with  a  tendency  towards  aggregation  at  the  upper  end 

of  Dalmarnock  Street  and  streets  adjacent  thereto,  in  Westniuir  Street  and 
in  the  streets  adjoining,  and  in  the  line  of  Great  Eastern  Road  towards  the 
eastern  boundary  of  the  City. 

(2)  London  Road  and  streets  east  of  Bridgeton  Cross,  and  again  beyond  its  junction 

with  Springfield  Road. 

(3)  Dalmarnock  Road. 

(4)  Springfield  Road. 

(5)  Main  Street,  Bridgeton. 

In  the  Southern  District  the  area  lies  between  Caledonia  Road  and  the  River,  and 
extends  eastward  in  the  direction  of  Oatlands,  while  sporadic  cases  have  occurred  in 
Crossbill,  Langside,  and  Mount  Florida. 

The  rapid  extension  of  the  disease  in  this  form  requires  the  concurrence  of  two  factors, 
which  may  be  thus  stated — the  free  movement  of  mild  and  unrecognised  cases,  and 
a  population  largely  susceptible  to  the  disease  from  inefficient  vaccination.  A  com- 
parison of  the  dates  of  sickening  in  a  very  striking  mamier  demonstrates  the  circum- 
stances under  which  this  took  place. 

I  have  been  able  to  ascertain  those  dates  in  306  of  the  cases  registered,  and  reproduce 
them  here — 


17 


Dates  of 

IN  U  HI  U  c  I  o 

Pates  of 

N  umbers 

Sickening. 

Sickening. 

Sickening. 

Sickening. 

Brought  forward, 

ou 

December 

.JO  LXlj 

January 

J) 

jyin,  ... 

i 

•) 

i.3tn. 

owtn, 

J 

?) 

1  If  It 

22 

^1  of 

!) 

1  PifVi 

1 0  xjli ,  ... 

January 

X  o  Uj  ... 

1 

1 

J5 

1  fifVi 

i  0  Lll, 

•^o 

•) 

. . . 

?* 

17th, 

)i 

3rd, 

1  J 

18th, 

40 

)S 

4th, 

i 

19th, 

30 

)! 

5th, 

; ) 

20th, 

23 

J> 

6th, 

— 

)! 

21st, 

16 

)) 

7th, 

•J 

22nd, 

5 

)! 

8th, 

3 

>? 

23rd, 

1 

)) 

9th, 

7 

)> 

24th, 

•> 

10th, 

15 

J? 

25th, 

!! 

11th, 

10 

26th, 

Carry  foricard. 

39 

308 

Dealing,  in  the  first  jDlace,  with  the  days  on  which  the  number  sickening  was  greatest,, 
we  have  a  period,  extending  from  the  13th  to  the  21st  January,  in  which  256  persons  were 
attacked,  and  the  scale  of  attacks  rises  towards  the  I7th,  when  43  persons  sickened. 

The  period  of  incubation  of  Smallpox  varies  from  the  ninth  to  the  seventeentli  day 
after  expostire,  the  majority  sickening  about  the  twelfth  day.  The  I7th  of  January 
would  therefore  correspond  to  exposure  to  infection  on  the  Saturday  of  the  New  Yeai^ 
holidays  (5th  Januaiy). 

By  the  7th  of  January  most  persons  had  returned  to  their  ordinary  occupation,  and 
the  rapid  decline  in  the  sickenings  occurring  in  the  third  week  of  the  year  is  quite  as 
striking  as  the  rapidity  of  the  increase,  which  began  more  than  a  week  earlier. 

This  analysis  might  be  joushed  somewhat  further  into  an  exjilanation  of  the  number' 
sickening  between  the  8th  and  12th,  fifteen  persons  having  sickened  on  10th  January, 
which  again  corresponds  with  an  exposure  at  the  end  of  Christmas  week,  when  many 
of  the  observances  of  the  season  had  in  part  commenced. 

The  outbreak  is,  therefore,  definitely  related  to  exposure  to  infection  occurring 
during  the  holiday  season. 

The  localities  involved  correspond  very  closely,  it  will  have  been  seen,  with  those 
in  which  isolated  cases  of  the  disease  were  known  to  have  been  occurring  for  some  con- 
siderable time  past;  in  these  districts,  therefore,  there  has  been  a  succession  of  cases 
quite  unrecognised  owing  to  their  mildness,  but  gradually,  from  their  numbers,  acquiring 
an  explosive  intensity  which  only  required  a  suitable  occasion  to  show  itself.  This 
came  with  the  holiday  season,  when  intimate  co-mingling  occurred,  and  the  mild  cases 
had  for  the  tune  being  a  newly-established  relationship.  That  this  has  proved  to  be 
a  susceptible  one  almost  beyond  belief  brings  home  most  forcibly  the  need  for  statutory 
re-vaccination  if  communities  are  to  be  protected  from  recurring  outbursts  of  the  disease 
at  intervals  of  years. 

In  June  last  the  Health  Committee,  in  view  of  the  then  distribution  of  Smallpox, 
recommended  the  population  to  have  recourse  to  re-vaccination,  and,  by  way  of  placing 
at  the  disposal  of  every  one  who  was  unable  i^o  pay  for  the  operation  an  opportunity 
of  having  it  done,  a  fee  was  paid  to  practitioners  for  all  such  operations  performed  by 
them.  The  result  of  this  appeal  was  extremely  disappointing,  and  even  under  con- 
ditions of  direct  exposure  to  infection  we  not  unseldom  found  that  an  offer  of  re^ 
vaccination  was  refused.  Several  of  these,  it  must  be  added,  are  now  in  Hospital  with 
Smallpox,  and  in  two  instances  at  least  death  has  occurred. 

At  the  present  moment  the  numbers  before  us  indicate  that  the  rush  of  cases 
created  by  the  holiday  period  has  passed,  but  a  secondary  rise  is  likely  to  occur  at  a 
period  corresponding  to  infection  on  the  I7th,  which  is  the  day  on  which  the  maximum 
amount  of  infection  is  known  to  have  been  present  among  the  population.    The  present 


18 


lull  in  the  occurrence  of  cases  is,  therefore,  not  to  be  taken  to  indicate  that  the  danger 
is  past. 

It  may  be  interesting  at  the  present  time  to  point  to  the  complete  exemption  from 
the  disease  enjoyed  by  the  Post  Ofi&ce  service.  The  members  of  this  service,  probably 
more  than  any  other  in  the  community,  are  brought  into  quite  definite  relationship 
with  every  infected  area,  and  yet  no  case  of  sickness  has  occurred  among  tliem.  It  is 
a  condition  of  this  sei-vice  that  each  member  be  efficiently  re-vaccinated. 

In  the  four  weeks  which  followed  a  steady  decrease  occurred  in  the  numbers 
registered  fortnightly,  but  this  was  again  followed  by  an  increasing  prevalence, 
indicated  first  by  the  number  of  admissions  to  Hospital  in  the  last  week  of  February, 
which  collectively  did  not  equal  that  which  we  have  just  seen,  but  extended 
throughout  a  period  of  three  weeks,  and,  in  consequence,  created  greater  public 
apprehension  than  the  larger  volume  of  the  earlier  rise. 

{^Extract  from  Report  for  Fortnight  ending  9th  March,  1901.) 

The  cases  of  Smallpox  registered  during  the  fortnight  numbered  299,  and  their  dis- 
tribution over  the  several  districts  is  shown  in  the  following  Table,  the  numbers  for  the 
three  preceding  fortnights  being  given  for  comparison — 

Fortnight  ending 


26tli  Jan. 

9th  Feb. 

23rd  Feb. 

9th  March. 

Eastern,  - 

256 

104 

67 

219 

Central,  - 

U 

20 

20 

30 

Northern, 

6 

22 

11 

18 

Southern,  - 

53 

37 

17 

26 

Western,  - 

2 

4 

2 

2 

South-Suburban, 

17 

14 

7 

3 

North-Western, 

2 

1 

3 

1 

350 

202 

127 

299 

After  an  interval  of  diminishing  prevalence  of  the  disease,  extending  from  1st  to  19th 
February,  an  increase  again  began,  which  was  first  indicated  in  the  number  admitted  to 
Hospital  on  23rd  February.  The  recrudescence  in  the  Eastern,  Central,  Northern,  and 
Southern  Districts  may  be  stated  as  an  increase  of  155  per  cent,  on  the  numbers  registered 
during  the  previous  fortnight,  but  vaiying  from  227  per  cent,  in  the  Eastern  to  50  per 
•cent,  in  the  Central  District.  In  relation  to  population,  there  were  13  attacks  per  10,000 
living  in  the  Eastern  District,  less  than  3  in  a  similar  number  in  the  Central  District,  2  in 
the  Southern,  and  1  in  the  Northern. 

The  occurrence  of  this  increase  after  an  interval  which  is  longer  than  the  maximum 
period  of  incubation  displaces  it  from  the  swing  of  epidemic  movement  which  marked 
17th  January  and  1st  February.  Wlien  the  increase  in  January  occurred  there  was  a 
definite  time  relationship  between  the  period  of  sickening  and  the  preceding  holiday 
season.  No  incident  of  a  similar  character  occurred  by  which  the  rapid  increase  in  the 
numbers  sickening  from  19th  February  may  be  accounted  for.  A  comparison  of  the 
dates  of  sickening  of  these  latter  cases  points  to  the  end  of  the  first  week  of  February  as 
a  period  when  an  active  dissemination  of  the  disease  took  place.  It  was  at  the  end  of  this 
week  that  the  daily  number  of  patients  under  treatment  was  at  its  greatest,  a  fact  which 
undoubtedly  suggests  the  introduction  of  a  new  factor,  the  operation  of  which  was  most 
probably  intensified  by  the  seasonal  conditions  under  which  it  occuiTed. 

In  the  fortnight  ending  23rd  March  161  cases  were  registered,  and  thereafter 
the  outbreak  rapidly  declined.  In  the  two  periods  of  greatest  prevalence  just 
referred  to  the  following  numbers  were  registered : — 

Fortnight  ending 

26th  January,       9th  February,  9th  March,       23rd  March, 

350  202  299  161 


19 


Pebiod  of  Recrudescence. 

The  history  of  this  may  be  shortly  told.  The  disease  first  reappeared  in  the 
Northern  District  of  the  City,  and.  in  contrast  with  what  had  occurred  during 
the  greater  prevalence  earlier  in  the  year,  certain  Model  Lodging-houses  were  now 
invaded,  owing  to  the  unrecognised  presence  of  cases  of  an  exceptionally  mild  type 
in  one  of  them  during  December. 

In  the  early  weeks  of  the  recurrence  the  cases  were  chiefly  drawn  from  the 
Northern  District,  but  in  the  fortnight  ending  22nd  February,  of  a  total  of  147  new 
cases  occurring  throughout  the  City,  102  occurred  in  the  Eastern  District,  and 
the  distribution  generally  reverted  to  the  lines  it  had  followed  earlier  in  the  year. 
The  following  extracts  contain  a  description  of  the  principal  features  which  it 
presented  : — 

{Extract  from  Report  for  Fortnight  ending  16th  November,  1901.) 

The  first  case  of  Smallpox  which  is  linown  to  have  occurred  in  the  City  since  29th 
June  last  was  admitted  to  Hospital  on  6th  current.  The  patient  is  a  spirit  salesman, 
employed  in  the  Northern  District,  and  also  residing  there.  He  sickened  on  -Slst  October, 
leaving  work  on  the  following  day,  but  liis  illness  was  believed  to  be  Measles  until  6th 
November  current,  v/hen  some  doubt  as  to  its  nature  arose,  and  we  were  informed  thereof. 
Patient  occupied  a  house  of  two  apartments;  his  family  includes  his  wife  and  two  young 
children,  and  there  were  three  male  lodgers.  He  had  not  been  re-vaccinated  in 
spring,  while  in  his  wife  and  one  lodger  the  operation  was  tlien  imsuccessful.  Two 
possible  explanations  of  the  source  of  infection  offer  themselves,  but  in  the  absence  of  all 
trace  of  illness  among  his  intunates,  the  possibility  of  his  obtaining  it  tlirougli  any  channel 
of  missed  infection  remaining  from  the  outbreak  in  spring  is  less  probable  tlian  that  it 
has  reached  him  through  one  suffering  from  a  mild  attack  of  the  disease.  It  is  consistent 
with  all  that  is  known  of  the  conditions  determining  the  incidence  of  Smallpox  that  a 
recurrence  of  the  disease  in  dissociated  centres  is  now  to  be  expected,  that  our  present 
case  is  only  the  first  illustration  that  mild  and  unrecognised  cases  most  probably  already 
exist,  and  that,  in  consequence,  the  occurrence  of  subsequent  disconnected  cases  is  to  be 
anticipated  as  the  winter  advances.  All  the  known  contacts  have  been  placed  under 
supervision,  the  household  being  removed  to  the  Reception  House,  where  those  formerly 
unsuccessfully  re^vaccinated  have  since  been  done. 

In  this  and  the  adjoining  tenement  50  out  of  76  persons  over  five  years  of  age  had  been 
re-vaccinated  in  spring.  Two  only  of  those  remaining  could  be  persuaded  to  takei 
advantage  of  tlie  offer  of  re-vaccination  again  made  on  the  occurrence  of  the  present  case. 
"The  census  showed  that  the  number  of  persons  over  five  years  of  age  within  the 
municipal  area  exceeded  670,000.  The  total  number  of  recorded  re-vaccinations  among 
these  amounts  to  slightly  over  400,000. 


{Extract  from  Report  for  Fortnight  ending  30th  November,  1901.) 

During  the  fortniglit  5  cases  of  Smallpox  Avere  registered,  as  against  1  in  tlie  pre- 
ceding  fortnight.  The  first  of  these  five  was  reported  on  20th  November,  having  sickened 
on  14th  November,  while  i^esident  in  a  Model  Lodging-house  in  the  neighbourhood  of 
Garscube  Road.  The  source  of  this  patient's  infection  was  not  ascertained  until  26th 
November,  when  a  second  case  (M.),  residing  in  202  Possil  Road,  was  notified. 
Here  the  patient  had  sickened  on  20th  November,  and,  on  enquiry,  a  tliird  case  (C), 
a  neighbour,  was  found  to  have  sickened  on  21st,  and  a  fourth  (J.  K.)  on  14th  November. 
All  of  these  are  secondaiy  to  an  attack  in  a  fifth  (K.  D.),  whose  illness  began  on  31st 
October,  and  who  had  almost  recovered  by  tlie  time  tlie  other  cases  came  to  be  mvesti- 
gated.  There  is  a  close  correspondence  between  the  beginning  of  this  last  patient's 
illness  and  that  of  the  patient  reported  last  fortnight.  Both  sickened  on  31st  October, 
but  othei-wise  they  appear  to  have  nothing  in  common.  None  of  the  six  cases  in 
Hospital  had  been  re-vaccinated. 

In  tlie  tenements  in  the  immediate  vicinity  of  the  infected  one  at  Possil  Road,  it 
has  been  found  that  during  the  vaccination  last  spring  279  persons  out  of  413  persons 


20 


living  over  five  years  of  age,  or  67  per  cent-.,  were  re-vaccinated,  and  this  has  been 
raised  to  84  per  cent,  as  the  result  of  the  present  cases. 

Since  May  last,  however,  re-vaccination  has  practically  ceased  among  the  general 
public. 

(^Extract  from  Report  for  Fortnight  ending  lJf.tlh  December,  1901.) 

The  cases  of  Smallpox  known  to  have  occurred  during  the  fortnight  were  four  in 
number.  One  attack  was  due  to  infection  contracted  in  London,  two  were  associated 
with  the  cases  reported  last  fortnight  occurring  at  202  Possil  Road,  and  the  fourth  case 
occurred  in  Springburn,  and  had  no  discoverable  connection  with  any  other. 

In  the  first  case  patient  arrived  on  29th  November  from  Tilbury,  and  sickened 
on  the  following  day,  the  rash  appearing  on  2nd  December.  The  family  which  this 
patient  was  visiting  in  Glasgow  consisted  of  five  adults,  three  of  whom  had  been  re- 
vaccinated  last  winter. 

The  cases  occurring  in  association  with  Possil  Road  are — 

1.  R.  G.,  residing  at  Rodney  Street,  sickened  on  1st  December,  the  eruption 
appearing  on  the  4th.  Patient  had  friends  at  202  Possil  Road,  and  was  a  frequent 
visitor  there.  Although  she  appears  not  to  have  visited  after  18th  November,  she  was 
visited  subsequently  at  her  own  house  by  persons  from  that  address. 

2.  Mrs.  P.,  residing  at  210  Possil  Road.  210  is  the  front  land  to  which  those 
tenements  entered  from  202  form  the  back  building.  The  husband  of  this  patient  is 
employed  in  connection  with  some  alterations  being  carried  out  in  the  houses  in  which 
former  cases  of  Smallpos  had  occurred,  and  he  himself  had  been  re-vaccinated. 

The  Springburn  case  sickened  on  2nd  December,  the  eruption  appearing  on  the 
4th.    This  patient  had  no  vaccination  mark,  and  says  she  understands  she  never  was  • 
vaccinated. 

(^Extract  from  Report  for  Fortnight  ending  11th  January,  1902.) 

In  the  first  week  of  the  fortnight  twenty-three  cases  of  Smallpox  were  admitted  to 
Hospital,  in  the  second  week  five  cases. 

These,  with  two  exceptions,  occurred  in  persons  who,  at  the  time  they  contracted 
the  disease,  were  inmates  of,  or  visitors  at,  a  Model  in  the  Northern  District,  and  they 
afford  another  illustration  of  what  will  happen  when  a  mild  case  is  permitted  to  live 
among  persons  who  are  only  partially  protected  by  vaccination.  This  Model  had  been  - 
under  observation  during  November,  and,  although  an  interval  of  freedom  from  infection 
occurred  between  the  case  then  removed  and  the  first  of  the  present  series,  we  may 
regard  them  as  at  least  indirectly  associated. 

The  outbreak  was  brought  under  notice  in  the  following  circumstances : — On  30th 
December  the  Local  Authority  of  Ayr  intimated  that  a  man  who  had  lived  in  this 
Model  between  the  7th  and  lltli  of  December  had  sickened  in  Ayr  on  the  22nd,  and, 
while  enquiry  was  being  made  into  this,  another  inmate  applied  for  parochial  relief, 
and  was  recognised  to  be  suffering  from  the  disease. 

The  enquiry  in  the  Model  had  already  led  to  the  discovery  of  two  other  cases; 
subsequently  a  man  was  discovered  whose  eruption  went  back  to  6th  December. 
Directly  associated  with  this  man  are  twenty  others  resident  in  the  Model,  one  being 
the  Superintendent,  who  had,  on  the  occasion  of  the  case  in  November,  assured  us  that 
he  had  been  re-vaccinated  last  April,  and  only  admitted  the  error  of  his  statement  when 
his  attack  declared  itself;  two  living  in  Models  elsewhere;  a  bedmaker  in  the  Model, 
but  living  in  M'Adam's  Lane ;  one  in  Possil  Road  and  one  in  Bernard  Street,  in  the 
Eastern  District,  both  of  whom  were  occasional  visitors  to  the  Model  in  question.  On 
the  recognition  of  the  outbreak  the  owner  was  informed  that  he  must  cease  admitting 
new  inmates,  and  a  circular  was  addressed  to  the  keepers  of  all  Model  Lodging-houses 
advising  them  of  the  occurrence,  and  inviting  their  co-operation  in  the  discovery  of 
suspected  illness.    The  affected  Model  is  under  nightly  medical  examination. 

In  this  Model  143  persons  were  re-vaccinated,  and  of  83  examined  within  the  fort- 
night 44  had  proved  successful  and  39  unsuccessful. 

In  addition  to  these  twenty-six,  two  other  cases  occurred  during  the  fortnight,  one 
in  St.  Vincent  Lane  and  one  in  a  Model  in  the  Eastern  part  of  the  City,  and  neither, 
so  far  as  is  known,  has  any  association  with  the  group  in  the  Northern  District.  With 


21 


i-egard  to  one  of  the  admissions,  a  male  patient,  aged  tliirty-tliree  years,  named  W.  B., 
it  falls  to  be  observed  that  he  says  he  was  successfully  re-vaccinated  three  years  ago 
in  one  of  the  Models,  and  that  two  marks  exist.  This  is  a  further  illustration  of  what 
has  already  been  said  in  connection  with  the  cases  occurring  last  year. 

[Extract  from  Report  for  Fortnight  ending  25th  January,  1902.) 

During  the  fortnight  2.3  cases  of  Smallpox  occurred,  as  against  28  in  the  preceding 
fortnight.  Of  these,  6  were  removed  from  the  Model  Lodging-house  in  the  Northern 
District  referred  to  formerly ;  4  were  removed  from  other  districts,  but  had  been  resident 
in  the  Model  at  the  time  of  contracting  the  disease ;  6  were  indirectly  associated  there- 
with; and  7  had  no  traceable  association.  Of  those  contracting  the  disease  in  the 
Home,  one  had,  prior  to  sickening,  gone  to  reside  in  the  Western  District ;  a  second 
sickened  in  the  Model  late  in  December,  but  had  gone  soon  thereafter  to  reside  with 
a  friend  in  Possilpark,  and  his  illness  was  only  recognised  when  his  friend  developed 
the  disease;  a  third  was  admitted  to  the  City  Poorhouse,  also  late  in  December,  and 
thereafter  developed  the  disease  in  so  mild  a  fomi  that  its  nature  was  not  recognised 
until  a  second  inmate  sickened;  and  a  fourth  was  known  to  have  been  present  with  a 
Smallpox  patient  in  the  consulting  room  of  a  surgeon,  and  refused  at  the  time  to  be 
re-vaccinated.  His  attack  affords  another  illustration  of  the  selective  action  of  the 
infection  of  Smallpox,  because  the  others  then  present  in  tlie  surgery  (save  a  young 
boy)  had  been  re-vaccinated  last  spring,  and  none  have  been  attacked  save  himself. 

Of  the  6  associated  cases,  2  were  removed  from  the  City  Poorhouse,  1  from  Bridge- 
ton,  1  from  Possilpark,  and  2  from  the  Northern  District. 

Early  in  the  fortnight  one  case  in  Bridgeton  was  brought  to  notice,  and  the  circum- 
stances suggest  that  endeavours  had  been  made  to  suppress  knowledge  of  its  existence. 
The  patient,  a  child  aged  ten  years,  on  being  seen,  had  been  ill  and  was  confined  to  bed 
for  over  two  weeks;  she  was  unvaccinated,  as  was  also  her  sister,  who,  along  with  the 
father,  have  since  developed  the  disease,  and  are  now  in  Hospital. 

[Extract  from  Report  for  Fortnight  ending  8th  February,  1902.) 

23  cases  of  Smallpox  were  registered  during  tlie  fortnight,  compared  with  a 
similar  number  during  the  previous  fortnight,  the  distribution  remaining  much  as 
formerly,  13  having  occurred  in  the  Nortliern  District,  4  in  the  Central,  and  3  in  each 
of  the  Eastern  and  Southern  Districts.  Inmates  of  Model  Lodging-houses  still  supply 
the  majority  of  the  cases  from  the  Northern  District,  3  having  occurred  in  that  which 
was  originally  infected  and  6  in  another  Model  in  the  neighbourhood.  The  other  cases 
here  were  removed  from  Church  Place,  Cowcaddens,  Mary  Street,  and  Springburn  Road, 
one  only  being  traceably  associated  with  the  Model  cases. 

In  the  Model  which  became  secondarily  infected  there  were  several  inmates  who 
had  formerly  been  seen  as  visitors  in  the  other. 

Of  the  3  cases  occurring  in  the  Central  District,  2  were  in  Model  Lodging-houses, 
.and  1,  removed  from  the  Calton  District,  is  associated  with  a  case  in  the  previous 
fortnight. 

Of  the  cases  occurring  in  the  Eastern  District,  one  is  father  of  the  child  referred 
to  last  fortnight  as  affording  illustration  of  an  endeavour  to  conceal  the  existence  of 
the  disease;  a  second  is  an  unvaccinated  baby  who  has  been  taken  to  visit  this  house- 
hold, but  information  thereof  withheld  until  the  sickness  occurred;  while  a  tliird  was 
a  worker  in  the  Provanmill  Gas-works,  and  associated  with  a  case  in  the  North  Wood- 
side  District. 

Of  the  3  cases  occurring  in  the  Southern  District,  1  is  associated  with  a  case  in 
Struthers  Street;  1  was  a  lodger  in  tlie  house  of  the  case  removed  during  the  previous 
fortnight,  and  was,  at  the  time  of  sickening,  under  observation  in  the  ReceiDtion  House ; 
and  in  1  the  origin  of  the  disease  cam:iot  be  traced. 

{Extract  from  Report  for  Fortnight  ending  22nd  February,  1902.) 
The  most  striking  featui-e  in  thci  movement  of  this  disease  during  tlie  past  fortnight 
has  been  the  sharp  increase  in  the  number  of  cases  occurring  during  the  first  week. 
Between  November,  when  the  first  cases  of  the  present  recrudescence  of  tlie  disease  began, 
and  the  end  of  December,  only  10  were  known  to  have  occurred  in  the  City,  9  of  which 
were  in  the  Northern  and  1  in  the  Southern  District. 


22 


In  the  first  fortnight  of  this  year  a  definite  association  of  cases  was  discovered,  as- 
described  at  the  time,  in  a  Model  Lodging-house,  also  in  the  Northern  District,  and  of  84 
cases  in  all  reported  prior  to  the  end  of  the  fortnight  ending  8th  February,  59  were  in  the 
Northern  and  only  8  in  the  Eastern  District  of  the  City.  During  the  fortnight  just  closed,, 
however,  the  area  of  distribution  has  not  only  widened,  but  the  incidence  has  changed,  asi 
is  shown  in  the  following  Table : — 


Central.  Eastern.    Northern.  Southern.  Western.      S.-S.  N.-W.  Total. 

16th  Nov.,  -  ...  ...  1  ...  ...  ...  ...  1 

30th     „  -  ...  ...  5  ...  ...  ...  ...  5 

14th  Dec,  -  ...  ...  3  1  ...  ...  ...  4 

28th    „  -  ...  ...  ...  ...  ...  ...   

11th  Jan.,  -       2  1  24  ...  ...  ...  1  28 

25th    „  -       4  3  13  2  1  ...  ...  23 

8th  Feb.,  -       3  4  13  3  ...  ...  ...  23 


9  8  59  6  1  ...  1  84 

Fortnight 

ending  22nd  Feb.,  12  102  14  7  3  2  7  147 

21  110  73  13  4  2  8  231 


The  circumstances  just  related  demonstrated  the  need  for  reverting  to  active 
re-vaccination  in  the  Eastern  District,  and  the  Special  Committee  authorised  the 
employment  of  twelve  additional  vaccinators,  who,  with  the  Inspectors,  form  a  corps  of 
about  thirty-one  officers,  which  is  nightly  engaged,  chiefly  in  the  Eastern  Districts  in 
infected  tenements,  but  generally  wherever  we  have  reason  to  believe  that  vaccination 
has  been  imperfectly  carried  out. 

{^Extract  from  Report  for  Fortnight  ending  8th  March,  1902.) 
During  the  fortnight  92  cases  of  .Smallpox  were  registered,  as  against  146  for  t\e 
previous  fortnight. 

Of  39  cases  occurring  in  the  Eastern  District,  29  occurred  in  Districts  7  and  8. 

Of  the  cases  in  the  Western  J)istrict,  12  have  been  associated  with  a  hotel  there, 
either  directly  or  at  the  time  they  contracted  the  disease.  As  a  result  of  this,  it  has  been 
necessaiy  to  instruct  the  proprietor  to  prohibit  new  admissions  until  a  fortnight  has 
elapsed  without  any  new  case  occurring.  The  staff  and  a  considerable  proportion  of  the 
visitors  accepted  re-vaccination. 

During  the  fortnight  the  first  illustration  has  occurred  of  Smallpox  attacking  one. 
of  the  employees.  In  this  case  the  patient  is  a  washerwoman,  employed  at  the  washing- 
house,  Belvidere,  who  was  permitted  to  begin  work  without  being  re-vaccinated. 

Several  illustrations  have  also  occurred  where  the  sickness  only  developed  after  a 
period  of  complete  confinement  to  the  house  for  longer  than  the  period  of  incubation. 
This  has  been  especially  noticed  in  connection  with  several  cases  in  the  Southern  District 
of  the  City,  and  suggests  the  diffusion  of  the  disease  by  vagrants  or  itinerant  vendors  of 
small  wares.  We  are  also  having  repeated  illustrations  of  the  selective  power  of  Smallpox 
infection  in  the  occurrence  of  the  disease  in  families  where  the  patient  alone  is  the  only 
member  unprotected  by  previous  re-vaccination. 

The  vaccination  corps  has  been  further  reinforced,  so  that  now  about  forty  operators 
are  engaged  nightly  in  pressing  re-vaccination  in  the  infected  districts.  An  almost 
complete  apathy,  however,  prevails,  and  little  re-vaccination  is  accomplished  save  in 
tenements  where  cases  occur. 

Little  advantage  is  being  taken  of  the  arrangements  formerly  made,  by  which  a  fee 
is  paid  by  the  Corporation  for  successful  re-vaccination  of  citizens  by  medical  practitioners. 

The  details  of  the  district  distribution  down  to  May,  1902,  is  contained  in 
Table  III.  Up  till  5th  April  the  disease  in  District  7  had  reappeared  in  36 
instances  in  a  tenement  from  which  cases  had  been  removed  during  1900-01,  but 
in  no  case  was  there  a  recurrence  in  the  same  house,  nor  were  any  patients  admitted 
in  whom  there  was  evidence  of  successful  re-vaccination  having  been  performed 
during  the  earlier  period  of  the  outbreak.* 


*  See  Kote  of  11th  January,  1902. 


23 


DISTRICT  DISTRIBUTION. 


The  number  of  cases  admitted  to  Hospital,  including  61  from  beyond  the 
City  boundary,  in  each  of  the  periods  was  as  follows  : — 

Cases.  Deaths.  Case-Mortalitj'. 

Pre-epidemic  Period — 

April— December,  1900,        ...         387  46  11-9 

Epidemic  Period — 

January— June,  1901,   1,423  192  13-5 

Recrudescence — 

November,  1901— 3rd  May,  1902,       469  ?  ? 

Pre-epidemic  and  Epidemic  Periods. 

Till  the  close  of  the  epidemic  period  the  cases  numbered  1,759,  only  10  of 
which  were  not  removed  to  Hospital,  the  attacks  having  ended  in  death  or  recovery 
at  home  before  their  nature  was  recognised.  Two  hundred  and  thirty-four  deaths 
occurred.  These  figures  represent  an  attack-rate  for  the  whole  population  of  2'3 
per  1,000,  a  death-rate  of  '3  per  1,000,  and  a  case-mortality  of  13'3  per  cent. 

In  Table  IV.  (p.  24)  the  population  of  each  Sanitary  District,  the  rmmber 
of  cases  and  deaths,  and  the  rate  per  million  of  population  is  stated,  the  grouping 
of  the  districts  being  arranged  from  those  in  which  the  disease  was  most  prevalent 
to  those  in  which  it  was  least  so.  The  cases  occurring  during  the  recrudescence  are 
not  included. 

The  unequal  incidence  of  the  disease  here  shown  will  best  be  appreciated  by  a 
comparison  of  the  attack-rate  in  the  several  districts. 

Greenhead  and  London  Road  (District  7)  had  an  attack-rate  of  9  9  per  1,000 
living,  which  is  fully  six  times  that  of  the  other  districts,  and  fully  four  times  that 
of  the  City  generally.  Next  in  point  of  severity  of  incidence  comes  Barrowfield 
(District  8),  which  lies  between  the  Greenhead  and  London  Road  sections  of  District 
7),  with  an  attack-rate  of  6'4  per  1,000.  District  11,  where  the  outbreak  began, 
stands  third,  but  here  the  rate  is  less  than  half  that  of  District  7,  and  barely  twice 
the  City  rate. 

Further  comparison  will  be  simplified  by  grouping  the  districts  according  to 
their  administrative  divisions,  as  in  the  following  Table  : — 

Population,  Cases,  and  Deaths  in  each  Administrative  District. 


Administrative  District. 

Population. 

Cases. 

Deaths. 

Rate  per 

Million. 

Case- 
Mortality 
per  Cent. 

Cases. 

Deaths. 

Eastern, 

173,104 

1,063 

134 

6,141 

692 

12-6 

Central, 

111,784 

216 

31 

1,932 

277 

14-4 

Southern, 

132,718 

239 

30 

1,801 

226 

12-6 

Northern,  ... 

166,825 

123 

19 

737 

114 

15-4 

"Western, 

61,092 

62 

9 

851 

147 

17-3 

South  Suburban,  ... 

64,205 

55 

10 

857 

158 

18-1 

North-Western, 

51,984 

11 

1 

212 

19 

9-1 

City,   

761,712 

1,759 

234 

2,309 

307 

13-25 

24 


Table  IV. — Return  of  Cases  and  Deaths  in  each  Sanitary  District. 


Cases. 

Deaths. 

Sanitaky  Districts. 

Population. 

Number. 

Rate  per 
Million. 

Number. 

Rate  per 
Million. 

Eastern. 

/.  Greenhead  and  Jjondon  Koad, 

00, 197 

660 

9  970 

7^> 

1  1  0"^ 

8.  Barrowfield,  ... 

1  /,o9o 

179 

fi  4.fi3 

9fi 

.5.  Bellgrove  and  Dennistoun,  . . . 

70  Oil 

224 

9  S98 

Central. 

11.  Calton, 

22,169 

94 

4,240 

12 

541 

6.  High  Street  and  Closes  East, 

7,102 

21 

2,907 

282 

9.  Monteith  Row,   

4,267 

1 

1 

9^1 

1-3.  Brownfield, 

3,924 

10 

12.  St.  Enoch  Square, 

Q  AAA 

\ 

000 

14.  Bridgegate  and  Wynds, 

o,ooU 

6 

1  54fi 

\ 

1.  Exchange, 

-J4,4:0  i 

34 

1,392 

S 

327 

10.  St.  Andrew  Square, 

4,  /  y* 

5 

1,043 

1 

209 

3.  High  Street  and  Closes  ^Vest, 

9,669 

8 

827 

1 

103 

Bl.  Blythswood,  

28,548 

22 

770 

4 

140 

South. 

2 1 .  Hutcheson  Square, 

146 

2,079 

18 

256 

Z/.  (jiorbais. 

1  OjUyo 

94. 

1,833 

9 

19.  Kingston, 

63 

1,559 

10 

247 

20.  Laurieston, 

o,yoo 

6 

668 

North. 

4.  tet.  rlollox., 

1  OAT" 

io,yu  / 

31 

1,948 

6 

377 

1 6.  Cowcaddens,  ... 

io,  JOo 

19 

L043 

4 

220 

—  Springburn  and  Rockvilla, 

35,527 

26 

732 

3 

84 

3 1 .  Possilpark  and  Barnhill, 

21,694 

11 

507 

1 

46 

1 5.  Woodside, 

70,145 

34 

485 

5 

71 

2,  Port-Dundas,  

5,346 

2 

West. 

18.  Anderston, 

28,858 

40 

1,386 

7 

243 

17.  Kelvinhaugh  and  Sandyford, 

32,234 

■^79 
0  1  ^ 

9 

fi9 

South-Suburban. 

24.  Crosshill,   

7,626 

11 

1,442 

2 

262 

23.  Govanhill,   

23,191 

26 

1,121 

5 

216 

27.  PoUokshields,  West,  and  Bella- 
houston. 

5,711 

5 

875 

25.  Langside  and  Mount  Florida, 

14,847 

9 

606 

1 

67 

26.  PoUokshields  and  Strathbungo, 

12,830 

•  4 

312 

2 

156 

North- West. 

28.  Hillhead,   

8.537 

4 

469 

30.  Maryhill,   

3.5,657 

6 

168 

1 

28  . 

29.  Kelvinside, 

7,790 

1 

128 

761,712 

1,759 

2,309 

234 

307 

Question  of  Hospital  Influence. 

During  the  progress  of  the  outbreak  it  became  obvious  that  some  circum- 
stance not  essential  to  epidemic  movement  was  determining  this  undue  prevalence 
in  the  Eastern  District. 

We  have  already  seen  that  early  in  June,  1900,  an  indication  of  this  had 
occurred.  As  the  outbreak  developed,  although  in  actual  numbers  the  cases 
from  this  district  were  largely  increased,  their  relative  proportion  to  cases  occurring 
elsewhere  was  only  slightly  raised. 

During  the  epidemic  prevalence  of  the  disease  early  in  the  seventies,  a  similar 
aggregation  of  cases  occurred  around  Parliamentary  Road  Hospital,  and  we  may, 
by  comparing  the  district  distribution  in  some  of  the  intervening  years,  discover 
whether  this  concentration  of  cases  in  the  neighbourhood  of  the  hospital  takes 
place  only  when  smallpox  is  epidemic,  or  whether  it  occurs  also  at  any  time  when 
cases  have  to  be  dealt  with. 

In  the  following  Table  this  is  calculated  for  each  of  the  years  in  which  Smallpox 
was  present  in  the  City  since  1892,  and,  for  purposes  of  comparison,  the  distribution 
of  the  cases  in  1900-1901,  and  the  proportion  of  population  residing  in  each  of  the 
districts  is  included  : — 


Smalllpox. — Peoportion  from  each  Administrative  District  op  the  Total  Cases 

OCCURRING  in  SeVERAL  YeARS. 


Percentage  of  Total  Cases. 

Year. 

Total 

Cases. 

East. 

Central. 

South. 

North. 

West. 

S.S. 

N.W. 

1900-\ 
1901  / 

1,759 

60-4 

12-3 

13-6 

7-0 

3  0 

31 

•6 

1892 

78 

28'2 

19-2 

26-9 

3-9 

20-5 

1-3 

1893 

386 

45-9 

24-7 

9-7 

128 

3-8 

•8 

2-3 

1894 

49 

32-7 

36-7 

16-3 

8-2 

2-0 

4-1 

1895 

243 

33-4 

140 

90 

5-8 

36-2 

•8 

•8 

1896 

5 

1897 

59 

57-6 

3-4 

32  2 

5-1 

1-7 

Percentage 
Population,  1901, 

1  23 

15 

17 

22 

8 

8 

7 

In  each  year,  therefore,  in  which  smallpox  has  been  present  the  proportion  of 
cases  contributed  by  the  Eastern  District  has  been  uniformly  in  excess  of  the 
proportion  of  the  population  residing  there. 

The  Central,  Southern,  and  Western  Divisions  in  occasional  years  present  a 
similar  excess,  but  this  is  due  in  most  cases  to  the  circumstances  under  which  the 
several  outbreaks  were  introduced.  The  excess  in  the  Eastern  District  is  constant^ 
and  in  none  of  the  other  districts  is  this  feature  present. 


26 


When  the  Eastern  prevalence  began  in  June,  1900,  the  ilumber  of  cases  in 
Hospital  was  comparatively  limited,  and  it  is  reasonable  to  assume  that,  if  simple 
aggregation  of  smallpox  creates  an  element  of  risk  to  surrounding  populations, 
this  risk  should  increase  with  the  densit}^  of  the  aggregation,  and  result  in 
an  exaggerated  prevalence  in  those  districts  which  are  exposed  to  it  when  compared 
with  those  which  are  beyond  its  influence. 

Could  a  gradation  of  risk  be  thus  established,  the  question  of  site  for  such 
hospitals  would  be  simplified,  because  it  might  be  assumed  that  some  standard  of 
cubic  space  per  patient  could  be  found  at  which  risk  would  be  reduced  to  a 
minimum,  if  not  entirely  abolished. 

In  the  preceding  Table  there  is  a  rough  indication  of  this  in  the  years  1895, 
1893,  and  1900-1,  when  the  numbers  dealt  with  were  243,  386,  and  1,759  respec- 
tively, and  the  proportion  of  Eastern  cases  33,  46,  and  60  per  cent. 

The  occurrence  during  the  present  outbreak  of  a  period  when  the  disease 
might  be  described  as  prevalent,  as  distinguished  from  a  subsequent  period  of 
epidemic  intensity,  afforded  a  further  opportunity  of  comparing  the  effect  which 
might  be  attributed  to  simple  aggregation  in  Hospital  with  that  occurring  during  a 
time  when  the  demand  for  accommodation  introduced  an  element  of  density  in 
the  aggregation,  and  necessitated  a  reduction  of  cubic  space  per  bed. 

The  proportion  of  the  total  cases  occurring  in  the  several  districts  during  each 
of  these  periods  is  as  follows  : — 


Administrative  District. 

Percentage 
Popiilation 

Proportion  per  cent,  of  Attacks 
TO  Total  Attacks  in  each  Period. 

(Census  1901). 

Pre-epidemic. 

Epidemic. 

Recrudescence 
till  5th  April. 

Eastern,  -       -       -  - 

23 

54-8 

61-8 

444 

Northern,       .       .  - 

22 

5-4 

7-3 

22-8  . 

Southern,        -       .  . 

17 

10-1 

14-8 

13-5 

Central,  -       -       -  - 

15 

22-2 

9-6 

104 

Western,        -       .  . 

8 

5-7 

2-2 

4-5 

South-Suburban, 

8 

1-5 

3-6 

1-6 

North-Western, 

,7 

0-3 

0-7 

3-4  . 

Again  it  will  be  observed  that  the  Eastern  District  alone  presents  in  each  of 
these  periods  a  proportion  of  the  total  attacks  much  in  excess  of  its  proportion  of 
the  total  population,  while  the  Central  District,  into  which  the  disease  was  intro- 
duced, has  likewise  a  larger  proportion  of  cases  than  of  population  in  the  first 
period,  which,  however,  is  not  maintained  in  the  second. 

We  are,  for  the  moment,  endeavouring  to  obtain  some  indication  of  a  relation- 
ship existing  between  the  volume  of  infection  contained  within  the  Hospital  as 
distinct  from  that  which  may  be  assumed  at '  least  to  follow  in  the  wake  of  a 
converging  stream,  both  of  patients  and  infected  clothing,  ])lus  the  opportunities 
for  acquiring  infection  through  contact,  which  the  occurrence  of  a  large  number  of 
cases  created  before  their  nature  was  recognised. 


If  a  numerical  relationship  be  established  between  the  cases  occurring  before 
and  after  the  beginning  of  the  year  1901,  this,  for  the  City  generally,  would  be 
expressed  by  the  proportion  of  1  to  3'5.  ^ 

In  the  Eastern  District  it  was  1  to  3  9,  but  these  formed  so  large  a  proportion 
of  the  total  that  the  difference  is  without  importance.  In  the  Northern  District, 
however,  the  relationship  is  as  1  to  S'G,  while  in  the  South  it  is  1  to  4-9 ;  in  other 
words,  there  was  almost  a  fivefold  increase  here  during  the  epidemic  period,  as 
compared  with  a  fourfold  in  the  Eastern  District ;  and  the  cases  in  the  Southern 
District  occurred  at  a  part  which  is  further  removed  from  Belvidere  than  any 
portion  of  Bridgeton. 

It  is  impossible  to  exclude  from  this  the  operation  of  widely  distributed 
opportunities  of  infection  which  we  know  existed,  but  a  comparison  of  the  pro- 
portion of  Eastern  cases  in  the  several  stages  of  invasion,  early  activity,  decrease, 
and  subsequent  epidemic  prevalence  of  the  disease,  shows  that  a  general  corre- 
spondence existed,  not  so  much  with  the  accumulated  numbers  under  treatment,  as 
with  the  fluctuations  in  the  number  of  admissions,  although  even  here  the  parallel 
breaks  down  when  applied  to  the  early  period  of  the  epidemic  increase. 


Proportion  of  Cases  occurring  in  each  District  to  Total  Cases  in  Several 

Periods. 


Period  Exdisg 

Total 
cases  in 

each 
period. 

Percentage 

OF  Total  Casts. 

East. 

Central. 

North. 

South. 

West. 

S.S. 

N.W. 

2nd  June, 

72 

25-0 

45-S 

19-4 

2-8 

2-8 

11th  August,  - 

159 

66-7 

14-5 

6-9 

10-1 

1-2 

0-6 

17  th  November, 

73 

53-4 

13-7 

1-4 

23-3 

l-i' 

4-1 

29th  December, 

93 

56-9 

18-3 

5-4 

17-2 

]  1 

11 

9  th  February, 

550 

65-5 

6-2 

5-1 

16-3 

M 

5-6 

0  2 

2.3rd  February, 

127 

52-7 

15-7 

8-7 

13  4 

1-6 

5-5 

2-4 

23  rd  March,  - 

460 

71-2 

10-0 

6-5 

9-2 

1  3 

1-3 

•5 

In  the  period  of  activity  between  2nd  June  and  11th  August,  1900,  67  pei 
cent,  of  the  cases  were  Eastern,  the  average  weekly  admissions  to  Hospital  at  the 
earlier  date  being  12-5;  during  the  period  of  autumnal  decrease — between  11th 
August  and  17th  November — the  proportion  of  admissions  from  the  Eastern 
Division  was  53  per  cent.,  while  the  weekly  admissions  averaged  5"2 ;  57  per  cent, 
of  the  admissions  from  the  middle  of  November  till  the  close  of  the  year  were 
Eastern,  during  which  period  the  average  weekly  number  of  admissions  was  15'5; 
that  it  rose  to  65  per  cent,  in  the  four  weeks  ending  9th  February,  when  the  weekly 
admissions  averaged  138,  and  to  71  per  cent,  in  the  four  weeks  ending  23rd  March, 
when  the  weekly  admissions  averaged  115. 


28 


The  proportion  of  Eastern  cases  during  the  epidemic  period,  but  especially  in 
the  four  weeks  ending  23rd  March,  seems  to  suggest  a  definite  time  relationship 
"with  the  numbers  under  treatment,  which  reached  their  maximum  on  8th  March, 
when  there  were  522  patients  in  Hospital,  but  a  comparison  of  the  fortnightly 
admissions  for  the  several  fortnights  of  this  period  does  not  confirm  the  impression.. 

Proportion  or  Cases  occurring  in  Eastern  District  to  Total  Cases  registered 
IN  Several  Fortnights,  with  Maximum  and  Minimum  Number  in  Hospital. 

DURING  THE  FOURTEEN  DaYS   PRECEDING  EACH  PERIOD. 

Fortnight  ending 
Jan.  26.     Feb.  9.    Feb.  23.    Mar.  9.   Mar.  23. 

73-1       514       52-7      73-2  67-7 

106        409        500       485  522 
98         96        409       387  394 

Here  an  equal  proportion  of  new  cases  Avas  occurring  in  the  fortnights  ending 
26th  January  and  9th  March,  although  the  numbers  admitted  in  the  fortnight 
preceding  each  {i.e.,  12th  January  and  23rd  February)  were  respectively  23  and 
127,  while  the  greatest  number  in  Hospital  in  each  of  these  last  fortnights  was  103 
and  485,  and,  in  contrast  to  both,  67'5  of  the  cases  occurring  in  the  fortnight 
ending  16th  June,  1900,  occurred  at  a  time  when  the  number  in  the  wards  was  67.. 

Again,  in  the  following  comparison,  we  find  that  in  Districts  7  and  8  about  one- 
third  of  the  total  cases  occurring  sickened  in  the  four  weeks  ending  2nd  February, 
while  the  proportion  occurring  in  the  four  weeks  ending  2nd  March  was  little  over 
a-fourth,  although  during  the  weeks  of  both  periods  the  numbers  under  treat- 
ment in  Ho^ital  were  rapidly  increasing.  In  March  again  only  16  per  cent.- 
occurred. 


Proportion  of  Cases  admitted  from  \ 
Eastern  District  to  total  for  V 
Fortnight,     -       -       -       -  j 

Maximum  under  treatment  during  ) 
previous  14  days,  -       -       -  / 

Minimum         do.  do., 


Percentage  op  Cases  occurring  during  Several  Periods  op  Four  Weeks  Each: 
TO  Total  Cases  sickening  in  Districts  5,  7,  and  8  during  Epidemic  Period. 


Four  Weeks 

Districts 

ending 

V. 

VII. 

VIII. 

2nd  February, 

28 

34 

32 

2nd  March,  

24 

26 

26 

30th  .,   

14 

16 

15 

These  comparisons  have  been  undertaken  with  the  double  object  of  ascertain- 
ing  whether  Smallpox  Hospitals  radiate  infection  in  a  degree  proportioned  to 
the  mass  of  infection  within  them,  and  whether  any  principles  might  be  deduced 
which  could  guide  further  policy  with  regard  to  Hospital  provision. 

In  the  1870-74  epidemic  the  disease  was  propagated  in  the  neighbourhood 
of  Parliamentary  Road  Hospital,  where  Smallpox  was  then  treated. 

During  the  limited  outbreaks  which  occurred  from  1892  onwards,  we  have 
found  a  preponderating  proportion  of  cases  invariably  contributed  by  the  Eastern, . 


29 


Districts.  In  the  maps  which  are  appended  illustrating  the  present  outbreak, 
there  is  no  aggregation  of  cases  beyond  the  mile  and  a-quarter  radius  from  the 
Hospital  which  at  all  corresponds  with  the  evidence  of  persistent  recurrence  of  the 
disease  within  it. 

We  have  seen  that  towards  the  end  of  May,  1900,  cases  began  to  occur  in 
the  immediate  neighbourhood  of  Belvidere,  which  indicated  exposiire  to  infection 
at  a  date  when  the  cases  under  treatment  barely  exceeded  30  daily. 

At  a  later  period,  increasing  numbers  in  Hospital  were  associated  with 
increasing  prevalence  in  its  neighboiirhood,  yet  their  proportion  to  the  total 
volume  on  each  occasion  varied  only  by  a  few  per  cent.,  while  the  numbers  in 
Hospital  were  multiplied  from  six  to  sixteen  times. 

There  is,  however,  a  general  correspondence  between  the  proportion  of  cases 
occurring  in  the  neighbourhood  of  the  hospital  and  the  numbers  dealt  with,  but 
this  is  lost  during  the  epidemic  period,  and  the  first  wave  of  epidemic  prevalence^ 
early  in  January,  1901,  cannot  be  brought  into  any  definite  relationship  with 
the  numbers  in  Hospital  when  it  began.  It  is  to  be  explained  rather  by 
widespread  distribution  of  infection  occurring  earlier,  while  with  regard  to  the 
subsequent  and  more  restricted  increases  towards  the  end  of  February  the 
conditions  had  altered,  because  in  the  Eastern  District  re-vaccination  was  being 
largely  resorted  to  with  every  recurring  wave  of  prevalence,  and  the  March 
increase  had,  in  consequence,  a  more  restricted  field  for  activity.  It  was,  moreover,, 
felt  elsewhere,  as  we  may  see  by  a  comparison  of  the  cases  in  the  Southern  District, 
during  this  phase. 

It  would  appear,  therefore,  to  be  a  not  unwarrantable  deduction  that  the 
risk  of  aggregation  begins  at  a  very  early  period,  and  tends  to  foster  a  prevalence 
of  the  disease  in  the  neighbourhood  of  Smallpox  Hospitals ;  but  that  when 
epidemic  virulence  is  established,  the  precise  influence  exerted  by  the  Hospital 
cannot  be  dissociated  from  that  caused  by  the  independent  centres,  which  it  has 
in  part  established. 

The  investigation  throws  no  light  on  the  channels  through  which  influence 
is  exercised,  except  what  is  of  a  negative  character.  The  Eastern  cases  began  when 
there  was  no  pressure  on  ward  space ;  they  reappeared  at  a  period  of  the 
recrudescence  when  this  was  being  specially  guarded  against ;  and  but  few  of  the 
cases  in  this  period  recurred  in  formerly  infected  tenements.  The  topographical 
relationship  of  the  Hospital  to  the  surrounding  population  outside  the  quarter  of 
a  mile  radius  does  not  admit  of  any  discrimination  between  the  effect  of  aggrega- 
tion and  the  precedent  volume  of  traffic,  both  in  patients  and  infected  clothing, 
through  the  main  thoroughfares  of  the  infected  district.  But  a  survey  of  the 
whole  circumstances  leads  inevitably  to  the  conclusion  that  the  excessive  pre- 
valence in  the  Eastern  District  has  established  the  unsuitability  of  Belvidere  for 
the  continued  treatment  of  Smallpox. 

In  respect  to  this  element  of  risk  to  the  neighbourhood.  Smallpox  Hospitals 
differ  from  those  for  the  other  infectious  diseases.  They  also  dilfer  in  another 
important  particular.  Since  the  last  epidemic  prevalence,  in  1870-74,  th6  pro- 
vision of  smallpox  accommodation  has  not  been  completely  taxed  until  the 
present  outbreak. 

In  the  present  outbreak  an  interesting  feature  bearing  on  this  was  disclosed. 
The  incidence  of  the  disease  at  ages  25-35  was  much  in  excess  of  that  at  any  other 
age  period,  and  indicates  that  in  communities  relying  solely  on  infantile  vaccination 


30 


the  conditions  on  which  epidemic  prevalence  depends  are  re-established  by  this 
period. 

In  these  circumstances,  how  to  meet  both  contingencies — a  recurring  epidemic 
prevalence  at  long  intervals,  and  the  added  risk  of  concentration  present  at  all  times, 
but  felt  most  when  the  pressure  is  greatest — is  the  problem  which  attends  all  effort 
to  map  out  a  policy  of  Smallpox  Hospital  provision.  To  maintain  several  Hospitals 
constantly  equipped  for  a  remote  contingency,  however  certain  may  be  its 
recurrence,  would  mean  waste.  A  certain  minimum  accommodation  must 
always  be  provided  to  meet  the  minor  fluctuations  of  prevalence  which,  occur 
between  epidemic  periods,  but  to  establish  this  as  the  sole  centre  of  aggregation 
in  epidemic  periods  results  in  producing  a  surrounding  mass  of  infection,  which 
may  be  dealt  with,  but  cannot  be  controlled.  To  escape  the  greater  risk  we 
should  avoid  the  concentration,  and  though,  as  our  experience  indicates,  a  certain 
degree  attends  all  aggregations,  we  might  still  be  able  to  accomplish  in  detail 
what  the  combined  volume  renders  impossible. 

Relation  of  Smallpox  Incidence  to  Districts  generally  presenting 

A  High  Death-rate. 

Insanitary  conditions  are  so  frequently  cited  as  explaining  the  excessive 
increase  of  Smallpox  in  any  particular  locality  that  we  may  enquire  whether  the 
recorded  death-rates  for  the  districts  chiefly  affected  afford  any  support  to  this. 

In  the  following  Table  the  average  general  death-rates  for  six  districts 
presenting  the  highest  rates  during  1898-1900  are  stated,  together  with  corre- 
sponding rates  for  Districts  5,  7,  and  8,  which  form  the  Eastern  Division,  and  the 
smallpox  attack-rate  for  each  : — 

Smallpox  Attack-rate  and  General  Death-rate,  1898-1900,  compared. 

"ni^TRTPT  Deaths  per  1,000     Smallpox  Attack- 


from  all  causes.         rate  per  1,000. 

13.  Brownfield,        -       -       .       -  33-06  2'5 

16.  Cowcaddens,       -       -       -       -  32-79  1-0 

6.  High  Street  and  Closes  East,      -  30-43  2-9 

2.  Port-Dundas,  -  -  -  -  29-55  -3 
22.  Gorbals,     -----  28-89  1-8 

3.  High  Street  and  Closes  West,     -  28-62  -3 

Glasgow,    -       -       .       -  20-6  2-3 


Eastern  Division. 

7.  Greenhead  and  London  Road,  -  22-0  9'9 

8.  Barrowfield,  .  -  -  .  25-7  6-4 
5.  Bellgrove  and  Dennistoun,  -  -  .          19-0  2-8 


There  is  no  suggestion  here  that  the  prevalence  of  insanitary  conditions,  as 
indicated  by  a  continuously  high  general  death-rate,  explains  the  excessive 
incidence  of  Smallpox  in  Districts  5,  7,  and  8. 


Again,  if  we  select  for  further  comparison  the  infantile  death-rate,  the 
Zymotics  (excluding  Smallpox)  and  that  from  Pulmonary  Diseases  (excluding 
Phthisis),  in  no  case  is  there  a  parallel  to  the  contrast  presented  by  the  death- 
rate  from  Smallpox  in  these  districts. 


Death-rate 
under  1  year 
per  1,000  born. 

Death-rate  per  Million. 

District. 

Zymotic 
Diseases. 

Respiratory 
Diseases  (not 
Phthisis). 

Smallpox. 

13.  Brownfield,   -       -       -  - 

207 

5,303 

8,934 

16.  Cowcaddens,  -        -       -  - 

218 

5,033 

9,379 

220 

6.  High  Street  and  Closes  East, 

3,839 

5,394 

282 

2.  Port-Dundas,        .       .  . 

-4,288 

8,150 

22.  Gorbals,        .       .       -  . 

209 

4,768 

7,487 

153 

3.  High  Street  and  Closes  West, 

177 

3,262 

6,597 

103 

City,       -       -  - 

153 

3,153 

4,617 

307 

7.  Greenhead  and  London  Koad, 

152 

4,319 

4,826 

1,103 

S.  Barrowfield,  -       -       -  . 

180 

4,813 

6,510 

939 

5.  Bellgrove  and  Dennistoun, 

U2 

3,185 

4,104 

442 

33 


AGE  INCIDENCE  OF  ATTACKS. 

In  the  following  Table  the  proportion  of  the  population  living  at  several  age 
periods,  together  with  the  proportion  of  cases  and  the  attack-rate  per  million 
living  at  each,  is  stated.  No  discrimination  is  here  made  between  vaccinated 
and  unvaccinated,  but  the  Table  shows  that  at  each  age  period  under  20  the 
proportion  of  attacks  is  smaller  than  the  proportion  of  population — that  22  per 
cent,  of  the  population  living  under  10  years  of  age  contribute  only  5"8  per  cent, 
of  the  total  cases,  while  21  per  cent,  of  the  population  living  between  the  ages  of 
15-25  contribute  22'5  per  cent.,  and  that  18  per  cent,  of  the  population  living  at 
ages  25-35  contribute  twice  that  proportion  of  the  cases.  There  were  almost  5 
attacks  per  1,000  living  between  25-35,  so  that  the  susceptibility  to  Smallpox 
at  this  period  of  life  is  considerable. 


Table  V. — Glasgow. —  Proportion  of  Population  and  Cases  at  certain  Age 
Periods,  showing  the  Number  of  Cases  and  the  Attack-rate  per 
Million  at  each. 


Ages. 

Proportion 
of 

Population. 

Proportion 
of 
Cases. 

Number 
of 
Cases. 

Attack-rate 
per 
Million. 

0—5 

11-9 

3-47 

61 

672 

5—10 

10-5 

2-39 

42 

526 

10—15 

9-8 

5-91 

104 

1,393 

15—20 

lO'l 

7-62 

134 

1,745 

20—25 

10-9 

14-89 

262 

3,143 

25—35 

17-5 

35-82 

630 

4,734 

35—45 

12-4 

20-01 

352 

3,731 

45—55 

8-6 

7-22 

127 

1,942 

55—65 

5-2 

1-76 

31 

775 

65  and  up. 

3-1 

0-91 

16 

684 

100-00 

1,759 

Infantile  Vaccination. 

This  contrast  in  the  age  incidence  may  be  viewed  together  with  what  is 
known  of  the  extent  to  which  the  requirements  of  the  law  in  respect  to  infantile 
vaccination  are  complied  with  in  Glasgow. 


34 


In  several  periods  tlie  proportion  of  children  "  not  accounted  for  "  in  the 
vaccination  returns  is  as  follows  :  — 

Return  of  Children  "not  accounted  for"  in  the  Vaccination  Returns  of 
Glasgow  Registration  Districts  in  Certain  Periods. 


Three  years,  1879-81,  ... 

1886-88,  ... 


Births. 

63,661 
64,189 


Removed  from  Districts 
before  Vaccination, 
or  otherwise  not  accounted  for. 
No.  Percentage. 
1,822  2-9 

1,359  2-1 


Glasgow. — Return  as  to  Vaccination  of  Children,  compiled  from  Supplement  to  the 
Monthly  and  Quarterly  Returns  of  the  Registrar-General  for  Scotland. 


1896. 

1897. 

1898. 

1899. 

1900. 

No. 

Per- 
centage. 

No. 

Per- 
centage. 

No. 

Per- 
centage. 

No. 

Per- 
centage. 

No. 

Per- 
centage. 

Successfully  vac- 
cinated, - 

20,348 

84-7 

19,932 

83-5 

20,080 

82-8 

20,191 

83-3 

20,512 

84-2 

Vaccination  post- 
poned, - 

274 

M 

259 

M 

256 

1-0 

215 

0-9 

162 

0-7 

Insusceptible  of 
Vaccination, 

214 

0-9 

212 

0-9 

184 

0-8 

201 

0-8 

196 

•8 

Died  before  vac- 
cination. 

2,546 

10-6 

2,808 

11-7 

2,918 

12-0 

2,865 

11-8 

2,785 

11-4 

Removed  from 
the  district,  or 
otherwise  not 
accounted  for, 

650 

2-7 

668 

2-8 

825 

3-4 

775 

3-2 

703 

2-9 

Total  Births  dur- 
ing year, 

24,032 

100-0 

23,879 

100-0 

24,263 

100-0 

24,247 

100-U 

24,358 

100-0 

The  reduction  in  the  second  period  (1886-8)  here  shown  expresses  the  result 
of  a  systematic  efiort  on  the  part  of  the  Sanitary  Department  to  reduce  the  portion 
"not  accounted  for"  in  those  years.  In  the  individual  years  1896-1900  the 
tendency  towards  an  increasing  proportion  again  becomes  manifest,  which 
reached  a  maximum  of  3"4  per  cent,  not  accounted  for  in  1898.  The  reduction 
in  the  proportion  occurring  in  1900  is  probably  the  result  of  the  stimulus  afforded 
by  the  presence  of  Smallpox. 

We  are  unable  to  ascertain  the  proportion  unaccounted  for  in  the  several 
Sanitary  Districts,  because  no  combination  of  these  will  quite  represent  the 
Registration  Districts,  but,  in  a  general  way,  Bridgeton,  Camlachie,  and  Dennis- 
toun  enter  largely  into  the  Eastern  Sanitary  Division,  and  Blythswood  and 
Milton  Registration  Districts  are  respectively  Central  and  Northern.  These 
are  selected  because  they  represent  in  one  case  the  area  where  Smallpox  was 
most  prevalent,  and  in  the  other  where  vaccination  was  most  neglected — Black- 
friars  being  unavailable  for  comparative  purposes  owing  to  the  presence  of  the 
Maternity  Hospital. 


35 


In  the  following  Table  details  corresponding  to  these  already  given  for  the- 
whole  City  are  given  for  the  Registration  Districts  for  the  years  1896-8 : — . 

Glasgow. — Births,  with  Number  and  Proportion  "  not  accounted  for  "  in 

Vaccination  Returns. 

Births,  Not  Accounted  fob. 


1896-8. 

Number. 

Percentage. 

Bridgeton, 

5,497 

122 

2-2 

Camlachie, 

5,648 

110 

1-9 

Dennistoun, 

7,553 

161 

2-1 

Calton,  ... 

3,495 

98 

2-8 

Blackf  riars. 

4,179 

262 

6-3 

St.  Rollox,   

5,386 

89 

1-7 

Blythswood, 

2,152 

83 

3-9 

Milton,  

4,735 

166 

3-5 

Kelvin,  ... 

5,453 

81 

1-5 

Anderston, 

4,555 

95 

2-1 

Hutchesontown, 

8,030 

270 

3-4 

Gorbals, 

4,418 

116 

2-6 

Tradeston, 

2,398 

73 

3-0 

Kinning  Park, ... 

1,465 

39 

2-7 

Total, 

...  64,964 

...  1,765 

2-7 

Age  Distribution  in  Relation  to  Vaccination  and  Fatality. 

In  the  subjoined  Table  all  admissions  to  Hospital  from  Smallpox  are  dealt 
with ;  the  numbers  include  61  from  neighbouring  Local  Authorities.  The 
vaccinated  and  unvaccinated  are  distinguished  from  those  in  whom  vaccination 
was  said  to  have  been  performed,  but  who  presented  no  discoverable  trace  of  the 
operation.  One-half  of  these  latter  were  confluent  in  type,  11  per  cent,  were 
haemorrhagic.  It  is  very  doubtful  whether  they  are  entitled  to  separate  classification. 
A  primary  vaccination  scar  is  practically  indelible,  and  any  local  reaction  follow- 
ing the  performance  of  the  operation  of  vaccination  which  does  not  result  in  a 
cicatrix  presenting  the  well-known  characters  is  scarcely  to  be  regarded  as  successful. 
At  every  age  save  those  under  10,  the  fatal  attacks  of  this  class  equal  or  exceed 
those  recovering,  but  the  numbers  here  dealt  with  are  small,  and  the  percentage 
fatality  consequently  liable  to  fluctuation.  It  is  probable  that  the  majority  are 
illustrations  of  persons  in  whom  the  operation  was  unsuccessful,  and  that  they 
should  be  included  in  the  unvaccinated  class : — 


36 


Table  VI. — Glasgow. — Smallpox,  1900-1. — Return  as  to  Vaccination  of  All  Cases  teeated  in 
Belvidere  Smallpox  Hospital  from  1st  April,  1900,  to  30th  June,  1901. 


Vaccinated. 

Unvaccinated. 

Vaccination 
Doubtful. 

Total. 

Age. 

© 

<a 

S-i 
0) 

.■S  a 

r-H  4) 

a) 

,— ■  (U 

<B 
U 

1— <  a> 

> 

o 
o 

o 
o 
a> 

p 

cS  O 

o  n 

> 
o 
o 

o 
M 

Q 

c3  o 

o  35 
g  ft 

> 
O 
O 
(U 

"(5 

eg  o 

1  53 

0 — 5  years, 

2 

1 

33-3 

18 

36 

66-6 

3 

23 

37 

61-7 

5—10  „ 

31 

10 

2 

16-7 

2 

43 

2 

4-4 

10—15  „ 

92 

1 

1-1 

10 

4 

28-6 

1 

1 

50-0 

103 

6 

5-5 

15—20  „ 

131 

4 

2 

333 

1 

1 

50-0 

136 

3 

2-2 

20 — 25     „  ... 

242 

12 

4-7 

2 

4 

66-6 

1 

2 

66-6 

245 

18 

6-8 

25—35  „ 

584 

42 

6-7 

6 

5 

45-5 

4 

9 

69-2 

594 

56 

8-6 

35—45  „ 

291 

51 

14-9 

8 

4 

33-3 

5 

6 

54-5 

304 

61 

16-7 

45—55  „ 

91 

26 

22-2 

1 

6 

85-7 

3 

4 

57-1 

95 

36 

27-5 

55—65  „ 

18 

13 

41-9 

1 

1 

50-0 

19 

14 

42-4 

65  years  and  over,  . . . 

10 

4 

28-6 

1 

100-0 

10 

5 

33-3 

All  Ages, 

1,492 

150 

9-1 

59 

63 

51-6 

21 

25 

54-3 

1,572 

238 

13-1 

This  Table  includes  Cases  from  beyond  City  Boundaries. 


Stunmarizing  this  Table,  the  broad  distinction  between  tlie  fatality  of  tlie 
vaccinated,  unvaccinated,  and  doubtfully  vaccinated  is  tbat  at  all  ages  tlie  deatb- 
rate  in  vaccinated  persons  was  9'1  per  cent.;  in  unvaccinated  persons,  61'6  per 
cent, ;  and  in  persons  doubtfully  vaccinated,  54' 3  per  cent. 

Regarding  tbe  single  fatal  case  occurring  in  the  vaccinated  column  under 
five  years  of  age,  it  is  to  be  observed  that  the  patient  was  a  boy  of  two  years,  with 
a  fairly  abundant  discrete  rash,  whose  vaccination  mark  was  '04  of  a  square  inch 
in  area,  was  glazed  and  not  foveated,  and  could  not  therefore  be  regarded  as 
evidence  of  satisfactory  vaccination. 

Beyond  this,  ratio  of  mortality  in  the  vaccinated  class  increases  until  the 
age  of  65  is  reached,  and  the  column  of  per  cent,  mortality  generally  in  this  class 
presents  a  striking  contrast  with  that  at  the  several  age  periods  in  the 
unvaccinated  class. 

Deaths  imder  Five  Years. — A  mortality  of  nearly  62  per  cent,  of  all  cases 
occurring  under  five  years  of  age  in  a  population  where  the  proportion  of  births  "  not 
accounted  for  "  in  the  vaccination  returns  average  less  than  3  per  cent,  will  arrest 
attention  and  requires  some  elucidation.  Of  these  cases  30  were  under  one 
year :  — ■ 

Glasgow. — Smallpox,  1900-1. — Cases  and  Deaths  under  One  Year. 


Recovered.         Died.  Total. 

Under  1  Month,        ...                             2               8  10 

„     2  Months                                     2               1  3 

„     3       „                                        _                1  1 

„     4       „                                          2               4  6 

„     5       ,                                        —               1  1 

„     6       „                                        _               1  1 

12       „                                          1               7  8 

7  23  .30 


37 


All  these  were  Tinvaccinated  prior  to  contracting  the  disease,  and  we  shall 
clearly  appreciate  the  significance  of  this  by  considering  the  age  incidence  more 
in  detail.  For  this  purpose  I  have  selected  two  periods  with  which  to  compare 
the  present  age  incidence  of  smallpox  deaths,  viz.,  1855-57,  being  the  early 
years  of  death  registration  (and  during  two  of  which  Smallpox  was  prevalent), 
and  1870-72,  when  it  was  also  present  in  epidemic  form. 


Table  VII. — Glasgow. — Smallpox. — Deaths  at  Certain  Age  Periods  in  1855-57, 
1870-72,  and  1900-01,  showing  the  Proportion  of  Total  Deaths  at  Each  Age. 


Ages. 

Deaths. 

Peecentage  of 

Total 

Deaths. 

loOt>-/. 

1900-01. 

loDo 

-5  / . 

1870-72. 

1900-01. 

Under  3  months, 

47 

24 

1  n 

iU 

6-4 

0  1 

4-2 

,,      b  ,, 

40 

32 

a 

D 

5-5 

o  y 

2-5 

„      1  year,   

161 

16 

/ 

22-1 

4  0 

3-0 

,,      2  years,  ... 

1  "79 

o 

ZO  0 

1-4^ 

„      3  „   

104 

5 

14-3 

1'4 

>50-5 

'  6-4 

5-9 

„      4  „   

53 

4 

7-3 

1-1 

,,      5  ,, 

O  iJ 

Q 

5-3, 

2-5. 

„     iU  ,, 

31 

43 

2 

4-3 

120 

0-8 

„    15  „   

10 

31 

6 

l-4\ 

8-7' 

2-5^ 

„    20  „   

15 

27 

3 

2-0 

7-6 

1-3 

„    25  „   

31 

59 

18 

4-3 

16-5 

7-6 

„    35  „   

17 

66 

56 

2  3 

18-4 

23-5 

|61-5 

183-6 

„    45  „   

6 

23 

61 

0-8 

6-4 

25-6 

„    55  „   

3 

8 

36 

0-4 

2'2 

15-1 

„    65  „   

5 

14 

0-0 

1-4 

5-9 

65  years  and  over, 

1 

5 

o-o/ 

0-3| 

2-lj 

All  Ages,  ... 

729 

358 

238* 

100-0 

100-0 

100-0 

*  Includes  Deaths  in  Hospital  of  Patients  from  beyond  City  Boundaries. 


The  broad  distinction  presented  in  these  Tables  has  often  been  pointed  out, 
and  may  thus  be  summarised  for  the  three  periods  :  — 

Proportion  of  Deaths.  1855-57.  1870-72.  1900-1. 

Under  10,    88-8  38-5  16-4 

Over  10,   11-2  61-5  83-4 

In  the  two  periods  of  life  here  contrasted  the  proportion  of  deaths  under  and 
over  10  years  of  age  becomes  almost  exactly  reversed.      But  the  Tables  are 


38 


interesting  from  anotlier  aspect.  In  tlie  first  two  periods  compared,  a  notable 
reduction  occurs  in  tlie  proportion  of  deaths  occurring  under  5  years  of  age, 
but  between  5  and  10  the  proportion  in  the  1870-72  outbreak  increases  just  as  do 
those  at  later  ages.  Indeed  the  contrast  presented  is  rather  as  between  ages 
under  and  over  5  years,  and  no  less  than  12  per  cent,  of  the  deaths  in  1870-72 
were  at  ages  5-10.  At  this  period  of  life  during  the  present  outbreak  less  than 
1  per  cent,  of  the  deaths  occurred,  and  the  increase  which  is  so  marked  in 
1870-72  is  obviously  the  result  of  a  large  number  of  susceptible  children 
existing  in  the  population  from  among  those  born  in  the  years  preceding  the 
commencement  of  the  Vaccination  Act  in  Scotland  in  1864.  Along  with  this, 
it  Avill  be  noted  that  the  six  months  which  elapse  between  the  birth  and  vaccina- 
tion of  a  child  in  Scotland  is  reflected  in  the  still  large  proportion  of  deaths 
occurring  in  the  early  months  of  infancy. 

Re-vaccination. 

The  Health  Committee  early  recognised  the  necessity  for  special  effort  being 
made  to  accomplish  re- vaccination  of  the  population,  and  on  11th  June,  1900,  the 
following  circular  was  issued,  with  their  approval,  to  medical  practitioners : — 

11th  June,  1900. 

Dear  Sie, 

SMALLPOX— RE-Y  A  CCINATION. 


Public  Health  (Scotland)  Act,  1897,  Sec  77. 

In  view  of  the  present  distribution  of  Smallpox  in  Glasgow,  the 
Corporation  (Police  Department),  as  Local  Authority,  desire  to  impress  on  the  com- 
munity the  extreme  desirability  of  each  of  its  members  acquiring  the  complete  pro- 
tection from  the  disease  which  recent  successful  re-vacoination  affords.  They  are  also 
desirous  of  affording  to  every  inhabitant  who  may  wish  to  be  re-vaccinated,  but  who 
cannot  afford  to  pay  for  the  operation,  facilities  for  having  it  done.  They  have  resolved 
to  exercise  the  power  conferred  upon  them  by  the  77th  Section  of  the  Public  Health 
(Scotland)  Act,  and  are  prepared  to  pay  to  practitioners  who  re-vaccinate  such  persons 
a  fee  of  Is.  6d.  for  each  successful  vaccination.  The  Corporation  believe  that  if  by 
any  means  they  could  obtain  the  re-vaccination  of  every  individual  in  Glasgow  above 
ten  years  of  age,  and  the  primary  vaccination  of  all  who  had  never  been  vaccinated,  an 
epidemic  prevalence  of  Smallpox  would  be  impossible  within  their  jurisdiction. 
The  conditions  of  payment  of  this  fee  are  these — 

1.  It  is  not  in  addition  to,  but  in  place  of,  any  private  fee. 

2..  The  name,  age,  address  in  full,  and  result  in  each  case  must  be  returned  to  me 
every  Saturday,  on  forms  to  be  supplied,  the  postage  of  which  will  be  repaid. 

3.  The  sums  due  will  be  made  up  from  these  lists,  and  paid  at  the  same  time  and 
in  the  same  way  as  fees  under  the  Infectious  Diseases  (Notification)  Act, 
viz.,  in  June  and  December. 

The  Corporation  rely  upon  your  active  co-operation  in  urging  all  persons  within 
the  scope  of  these  conditions  over  whom  you  have  influence  to  take  advantage  of  this 
opportunity  of  putting  themselves  beyond  the  reach  of  Smallpox. 

I  am, 

Yours  truly. 


A.  K.  CHALMERS, 

Medical  Officer  of  Health. 


39 

Special  representation  was  also  made  to  every  employer  of  labour  among 
whose  workers  any  case  of  the  disease  was  recognised,  and  the  Tramways  Committee, 
through  their  General  Manager,  set  an  excellent  exainple  duriag  this  month  in 
procuring  the  re-vaccination  of  all  their  employees.  But  with  the  diminishing 
number  of  fresh  cases  as  the  summer  advanced,  interest  in  the  question  was 
practically  confined  to  the  immediate  neighbourhood  of  the  cases,  and  to  the 
factories  where  they  were  employed.  This  is  best  illustrated  by  contrasting  the 
number  of  persons  re-vaccinated  at  their  own  residences — in  and  around  infected 
tenements — with  the  number  of  those  availing  themselves  of  the  offer  through 
medical  practitioners,  as  given  in  the  following«Table : — 

Summary  op  the  Vaccinations  and  Re-vaccinations  done  by  the  Officers  of  the 
Sanitary  Department  and  by  Practitioners  during  1900. 

Primary.  Secondary. 

At  Office,                                                              550  264 

At  Hospitals,                                                                7  205 

At  Residence,  by  Staff  of  Department,  ...        ...           5  6,372 

By  Practitioners,  in  terms  of  circular  of  11th  June,        8  964 

In  Prisons,           ...        ...        ...        ...        ...         —  196 


Total,    570  8,001 


When  the  rapid  increase  in  the  number  of  admissions  to  Hospital  during 
January,  1902,  gave  ample  evidence  that  the  outbreak  was  assuming  proportions 
quite  unknown  locally  in  recent  years,  a  second  circular  to  practitioners  was  issued, 
which  differed  in  two  important  particulars  from  the  earlier  one.  It  reduced  the 
age  limit  for  re-vaccinations  to  five  years  because  of  the  number  of  children  admitted 
with  trifling  vaccination  cicatrices,  and  withdrew  the  stipulation  regarding  the 
inability  of  the  person  desiring  re-vaccination  to  pay  a  fee  for  the  operation. 
This  circular  was  in  the  following  terms  : — 

Sanitary  Department,  23  Montrose  Street, 
Glasgow,  24th  January,  1901. 

CIRCULAR  LETTER  TO  PRACTITIONERS. 


Smallpox — Re-v^ccination. 

Dear  Sir, 

In  June  last  the  Health  Committee  issued  a  circular  to  prac- 
titioners inviting  them  to  urge  the  desirability  of  re-vaccination  on  all  with  whom  they 
had  influence.  The  response  to  this  was  extremely  disappointing,  lai'gely  because  of 
indifference  to  re-vaccination,  resulting  probably  from  the  limited  number  of  the  cases 
of  Smallpox  occurring  at  that  time.    The  circumstances  are  now  much  altered. 

Smallpox  has  assumed  alanning  proportions.  Already  the  number  of  cases  occur- 
ring daily  exceeds  anything  which  the  City  has  experienced  since  1873,  and  although 
at  the  present  moment  the  greatest  prevalence  is  in  Parkhead,  Biidgeton,  Dalmarnock, 
and  the  Eastern  Districts  of  the  City  generally,  there  are  indications  that  other  districts, 
notably  Gorbals,  Govanhill,  and  Anderston,  are  on  the  eve  of  a  similar  expansion  of  the 
disease.  Nothing,  save  a  general  recourse  to  re-vaccination,  will  prevent  its  spread 
throughout  the  City  generally. 

In  the  circumstances  the  Health  Committee  would  again  invite  your  active  co- 
operation in  urging  re-vaccination.  They  are  thoroughly  convinced  that  if  every  con- 
sulting room  became  an  active  re-vaccinating  centre  many  lives  would  be  saved,  the 
virulence  of  the  present  outbreak  would  rapidly  become  moderated,  and  an  invaluable 
service  be  rendered  alike  to  the  Corporation  and  the  community. 


40 


The  Committee  are  therefore  prepared  to  pay  for  the  successful  re-vaccination  of 
any  person  over  five  years  of  age  a  sum  of  Is.  6d.,  under  the  following  conditions: — 

1.  The  name,  age,  address  in  full,  and  result  in  each  case  must  be  returned  to  me 

every  Saturday,  on  forms  to  be  supplied,  the  postage  of  which  will  be  repaid. 

2.  The  sums  due  will  be  made  up  from  these  lists,  and  paid  at  the  same  time  and 

in  the  same  way  as  fees  under  the  Infectious  Diseases  (Notification)  Act^ 
viz.,  in  June  and  December. 

3.  Lymph  will  be  supplied  on  application  (personally  or  by  messenger)  at  the 

Sanitary  Office. 

As  many  of  the  cases  occurring  among  imperfectly  vaccinated  persons  are  of  a 
mild  and  modified  type,  the  recog-nifeion  of  Smallpox  is  apt  to  be  extremely  difficult, 
and  this  is  enhanced  by  the  fact  that  it  is  in  these  cases  that  the  various  prodromal 
eruptions  are  apt  to  appear.  These  eruptions  bear  no  resemblance  to  the  true  variolar 
eruption,  but,  on  the  contrary,  may  closely  simulate  typhus  fever,  scarlet  fever,  or 
measles. 

With  the  object  of  facilitating  the  recognition  of  such  cases,  I  append  the  following 

note. 

I  am,  Deae  Sir, 

Yours  truly, 

A.  K.  CHALMERS. 

N.B. — Efficient  vaccination  is  only  to  be  obtained  when  the  total  area  of  vesiculation 
produced  is  not  less  than  half  a  square  inch  in  size  on  the  eighth  day,  and  a  similar 
result  should  be  aimed  at  in  re-vaccination. 

A.  K.  C. 


Appendix. 

Prodromal  eruptions,  which  are  apt  to  be  veiy  puzzling,  may  assume  the  foUowing^ 
forms : — 

1.  The  most  common  is  general  erythema,  closely  resembling  the  rash  of  scai-let 

fever,  affecting  chiefly  the  trunk,  but  passing  later  to  the  extremities.  Thisi 
eruption  may  persist  after  the  true  papular  eruption  has  been  out  for  a  day 
or  two. 

2.  A  coarsely  punctate  erythema,  sometimes  becoming  petechial,  appears  on  the  groin 

and  sides  of  the  abdomen.  It  is  generally  confined  to  a  triangular  area, 
bounded  above  by  an  imaginary  line  crossing  the  abdomen  transversely  a 
little  below  the  umbilicus,  and  bounded  laterally  by,  lines  passing  from  the 
iliac  crests  to  an  imaginary  point  about  four  inches  below  the  pubes. 

3.  A  dusky  brown  tint,  not  very  obvious,  and  fading  on  pressure,  generally  over  lower 

part  of  trunk,  especially  in  lumbar  and  sacral  regions. 

4.  A  morbilliform  eruption,  closely  resembling  a  measles  or  typhus  rash,  appears  in 

ill-defined  patches  on  the  trunk. 

HEMORRHAGIC  SmaLLPOX. 

In  this  form  the  symptoms  of  invasion  are  very  severe.  The  face  and  limbs  may 
remain  perfectly  normal  in  appearance.  There  is,  in  the  complete  form,  no  papular 
eruption  at  all ;  in  less  marked  forms,  the  papular  eruption  is  very  scanty  and  irregularly 
developed.  It  begins  with  a  well-marked  erythema  on  the  trunk,  especially  over  the 
lower  part  of  abdomen.  This  rapidly  extends  and  becomes  livid  in  tmt,  and  may  finally 
involve  the  whole  trunk.  Petechite,  of  variable  size,  soon  make  their  appearance,  in 
addition  to  the  general  staining. 

Blood  may  be  voided  by  all  the  mucous  surfaces,  and  the  ocular  conjunctiva  may 
become  black  owing  to  haemorrhage. 

Early  in  the  disease  the  eruption  may  be  mistaken  for  that  of  typhus. 

N.B. — It  is  of  the  greatest  importance  that  every  anomalous  rash  or  suspicious  cases 
of  illness  should  be  at  once  intimated  to  the  Medical  Officer  of  Health. 


41 


The  immediate  result  of  these  was  to  convert  the  consulting  rooms  of  practi- 
tioners in  infected  districts  into  vaccination  stations,  where  the  work  of  re-vaccination 
went  on  frequently  for  hours  daily.  This  activity  continued  untii-the  second  wave 
of  prevalence  in  the  beginning  of  February  had  subsided ;  but  in  the  report  for 
the  fortnight  ending  23rd  February  I  had  occasion  to  observe  "  that,  while  the  re- 
vaccinations  reported  during  the  fortnight  numbered  77,652,  as  against  36,812  in  the 
previous  one,  the  quantity  of  lymph  issued  during  the  past  week  by  the  Department 
to  practitioners  has  shrunk  to  such  an  extent  that  the  amount  of  active  re-vaccina- 
tion now  going  on  in  the  community  must  be  very  far  short  of  that  done  during 
previous  weeks.  This  is  much  to  be  regretted,  because  the  seasonal  conditions 
which  favour  the  spread  of  Smallpox  reach  their  acme  in  the  spring  months,  and 
the  approach  of  this  period  must  be  regarded  with  some  apprehension  if  the  apathy 
regarding  vaccination,  which  is  again  becoming  manifest,  continues."  It  is  possible 
that  the  resolution  of  the  Special  Committee  appointed  to  deal  with  the  epidemic, 
to  cease  publishing  the  number  of  fresh  cases  occurring  daily  at  this  time,  helped, 
in  part,  to  confirm  the  impression  created  by  the  diminishing  numbers ;  but  it  has 
been  a  frequently  repeated  experience  of  the  Department  that  the  number  of 
re -vaccinations  which  it  is  possible  to  obtain  rise  and  fall  with  the  number  of  cases 
of  Smallpox  occurring,  and  that  prudential  motives  are  apt  to  remain  in  abeyance 
unless  stimulated  by  present  risk. 

The  recurring  increase  in  the  number  of  admissions  to  Hospital  early  in  March 
led  to  the  adoption  of  a  system  of  house-to-house  visitation  in  certain  districts,  on 
the  lines  indicated  in  the  annexed  circular : — 

Sanitary  Chambers,  23  Montrose  Street, 
Glasgow,  7th  March,  1901. 

CIRCULAR  LETTER  TO  MEDICAL  PRACTITIONERS. 


Dear  Sir, 

Smallpox — Re-vaccixation. 

The  Executive  Committee  gratefully  recognise  the  response  recently 
made  by  practitioners  to  my  circular  of  28th  January  last  inviting  them  to  /perform 
re- vaccination  on  any  who  chose  to  avail  themselves  of  the  offer  then  made.  They  feel, 
however,  that  further  effort  is  required  to  reach  those  who  are  indifferent  to  the  present  risk, 
and  that  this  can  best  be  secured  by  a  systematic  visitation  from  house  to  house  in  certain 
districts  of  the  City,  and  they  desire  me  to  invite  your  co-operation  in  this  work. 

Such  a  scheme  would  be  based  on  the  Census  Enumeration  Districts.  These  districts 
vary  in  size,  but  on  an  average  each  contains  about  1 50  houses,  distributed  over  from  1 2 
to  15  tenements.  This  number  might  readily  be  covered  within  a  week  by  taking  two 
tenements  each  evening,  which  is  the  only  time  when  the  majority  of  the  inmates  are 
likely  to  be  found  at  home. 

The  Committee  feel  assured  that  they  can  with  confidence  rely  on  tlie  co-operation 
of  the  medical  profession  in  this  further  effort  to  secure  the  re-vaccination  of  the 
remaining  portion  of  the  population,  and  a  post-card  is  enclosed,  which  I  have  to  ask 
you  to  be  good  enough  to  forward  me  by  return  post,  stating  whetlier  you  can  find  time 
to  devote  to  the  work.    For  each  vaccination  so  obtained  a  fee  of  2s.  6d.  will  be  allowed. 

Yours  truly, 

A.  K.  CHALMERS. 


42 


While  the  medical  practitioners  were  thus  invited  to  take  up  district  visitation 
on  these  lines,  the  officers  of  the  Department  were  aided  in  the  work  of  vaccination 
by  a  special  corps,  ultimately  numbering  484,  and  composed  of  254  students  of 
medicine,  and  230  others,  chiefly  drawn  from  other  departments  of  the  Corporation 
service,  and  working  under  the  direction  of  Dr.  Carmichael,  Vaccinator  to  the  Depart- 
ment. The  energies  of  this  corps  were  directed,  in  the  first  place,  to  the  neighbour- 
hood of  those  streets  where  Smallpox  was  occurring,  but  as  soon  as  possible  they  were 
distributed  over  the  Census  enumeration  areas.  It  also  became  possible  to  take  a 
census  of  the  condition  of  these  districts  in  respect  to  vaccination,  the  returns, 
however,  being  based  wholly  on  the  verbal  statement  of  the  person  in  charge  of 
the  household  at  the  time  of  the  visit. 

It  is,  unfortunately,  impossible  to  state  with  any  degree  of  accuracy  the  extent 
to  which  re-vaccination  had  been  carried  at  this  period  in  the  community  generally,, 
because  information  on  this  point  would  supply  the  answer  to  the  question  whether 
any  considerable  section  of  a  community  exposed  to  a  known  risk,  and  with  every 
facility  offered  of  protection  against  it,  are  so  completely  indifferent  to  both  that 
the  means  of  protection  must  be  brought  to  them  before  they  will  avail  themselves 
of  it.  When  the  house-to-house  visitation  began  in  March,  the  census  appeared  ta 
indicate  that  53  per  cent,  of  the  population  over  five  years  had  been  recently  re- 
vaccinated.  This  would  represent  355,570  persons  on  whom  the  operation  had 
already  been  performed,  which,  however,  is  in  excess  of  the  total  for  which  payment 
was  made  by  the  Corporation  during  the  whole  outbreak,  and  is  only  49,695  less 
than  is  shown  by  the  completed  returns  of  the  year.  Together  with  those  obtained 
in  1900,  this  gives  a  total  of  405,265,  and  would  appear  to  indicate  that  house-to- 
house  visitation,  directly  and  indirectly,  resulted  in  procuring  an  addition  of  over 
49,000  from  those  who  had  previously  proved  indifferent. 

Till  the  close  of  the  fortnight  ending  March  9th,  over  157,000  re-vaccinations 
had  been  recorded,  as  shown  in  the  following  Table,  but  this  represents  only  23  per 
cent,  of  the  population  over  five  years  of  age.  Of  these,  146,000  had  been  done  by 
practitioners,  but  the  dates  on  which  the  returns  were  received  were  not  closely 
related  to  the  fortnights  in  which  the  vaccinations  had  been  performed,  and,  even 
when  all  had  been  returned,  the  information  afforded  did  not  readily  lend  itself  to  a 
detailed  tabulation  of  the  numbers  performed  in  successive  weeks. 

It,  is  probable,  therefore,  that  the  estimate  of  53  per  cent,  is  in  excess  of  the 
proportion  already  re-vaccinated  by  the  beginning  of  March,  and  the  annexed  Table, 
showing  the  number  of  tubes  of  calf  lymph  issued  by  the  Department  to  medical 
practitioners  fairly  reflects  the  ebb  and  flow  of  the  demand  for  re-vaccination  in  the 
various  districts  : — 


43 

Table  op  Tubes  of  Glycerixated  Calf  Lymph  issued  to  Practitiosers. 


Date. 

January. 

February. 

March. 

April. 

1 

4,557 

440 

232 

0 

670 

755 

120 

3 

170 

130 

4 

3,104 

1,664 

140 

5 

3,849 

2,295 

145 

6 

3,006 

2,319 

120 

7 

3,009 

3,359 

8 

3,799 

4,047 

80 

9 

2,789 

1,925 

130 

10 

100 

70 

11 

2,007 

2,499 

105 

12 

2,204 

3,066 

155 

13 

1,292 

1,860 

40 

14 

895 

2,489 

5 

15 

998 

2,600 

35 

16 

594 

2,255 

10 

17 

30 

18 

436 

1,516 

10 

19 

609 

1,962 

20 

439 

1,064 

30 

21 

383 

880 

22 

164 

45 

23 

280 

847 

11 

24 

'  80 

25 

400 

550 

26 

355 

330 

27 

2,776 

599 

220 

^0 

0  9 in 

ooo 

-1 1  O 

9n 
^yj 

29 

4,055 

140 

15 

30 

4,707 

200 

28 

31 

4,363 

18,141 

37,143 

39,737 

1,706 

Average  Daily  Issue — February,  1,326;  March,  1,281. 


44 


Summary  of  the  Vaccinations  and  Re-vaccinations  done  by  the  Officers  op  the 


SaiVTTATJV    'D'PP  a  PTAT'n''NrT    ATCn    TIV    "Pr?  APTTTTONF.TJS 
KJ  AIN  i  1  AJK.  I     J-/ Jjjr^2i.IV -L  iVlJCjPl  i-     AlAi-f     13  1.      J_  J.V X  1  X  1.  V/il  l-iitO 

DURING 

1901. 

Primary. 

Secondary. 

At  Office,   

^  433 

486  ■ 

In  HosDitals,  ... 

11 

556 

At  Residence,  by  Staff  of  Department, 

_ 

14,763 

In  Prisons  and  Poorhouses,  ... 

24 

11,293 

By  Practitioners,  in  terms  of  circular  letter  of  24th 

January,  1901, 

— 

283,423 

j3y  Special  Vaccinators    working  in  Enumeration 

Districts,  ... 

— 

29,081 

By  Practitioners  in  Enumeration  Districts,  in  terms 

of  circular  letter  of  7th  March,  1901,  ... 

— 

12,424 

468 

352,026 

In    reply  to  a   circular    letter,   447  Practitionei'S 

intimated  that,  in  addition  to  those  done  for  the 

Corporation,  they  had  done  private  re-vaccina- 

tions numbering  ... 

45,238 

Total  re-vaccinations,  ... 

397,264 

Add  for  1900,  ... 

8,001 

Add  for  1902  to  3rd  May, 

7,972 

413,237 


Re-vaccination  in  Relation  to  Attack. 

In  126  cases  admitted  it  was  found  that  re-vaccination  had  recently  been 
performed,  and  the  following  figures,  taken  from  a  Table  compiled  by  Professor 
R.  S.  Thomson,  Visiting  Physician  to  the  Smallpox  Hospital,  and  Dr.  Fullarton, 
Resident  Physician,  show  the  number  of  days  intervening  between  the  successful 
performance  of  the  operation  and  the  development  of  symptoms  of  Smallpox  :  — 

Number  of  Days  before  Sickening — 

0      1      2      3      4      5      6      7      8      9      10      11      12  13 
Number  of  Cases  — 

6    11      3      7    20    17      6    11    13      4       1      —       1  1 

If  we  assume  that  twelve  days  represents  the  average  period  of  incubation, 
then  the  chances  of  escape  are  still  very  considerable,  although  the  re-vaccination 
may  be  postponed  until  the  third  day  after  exposure.  In  a  small  number  of  cases 
re-vaccination  had  been  performed  successfully  before  the  attack  occurred,  but 
these  are  at  intervals  of  years,  and  the  following  Table,  also  prepared  by  Drs. 
Thomson  and  Fullarton,  shows  the  interval  between  re-vaccination  and  attack,  and 
the  character  of  the  latter : — 


45 


Table  showing,  in  Cases  successfully  re-vaccinated  before  Infection,  the 
Period  between  Re-vaccination  and  Attack  and  the  Influence  of  Re- 
vaccination  ON  Severity  of  Attack.* 

Case.  Primary  Vaccination.    Date  of  Re- vaccination.       Character  of  Attack. 


H.  B. 

aged 

25 

1 

mark- 

—poor 

6 

years  ago 

Very  sparse. 

Mrs.  M'L. 

J' 

43 

1 

11 

fair 

11 

Sparse. 

G.  C. 

jj 

44 

1 

l; 

poor 

21 

11 

Very  sparse. 

W.  W. 

)) 

37 

1 

11 

poor 

27 

11 

Fairly  abundant. 

J.K. 

)j 

48 

1 

11 

poor 

28 

11 

Very  sparse. 

J.  R. 

II 

43 

3 

M 

poor 

31 

11 

Sparse. 

P.  M'L. 

)) 

42 

2 

11 

fair 

32 

11 

Very  sparse. 

A.  S. 

11 

28 

1 

11 

fair 

(?)  4 

1' 

Fairly  abundant. 

Statement  as  to  Vaccination  op  Cases  admitted  to  Hospital  during  Period  of 


Recrudescence,  1901-1902. 


Age. 

Total. 

Vaccinated. 

Un  vaccinated. 

Doubtful. 

Under  5  years,  ... 

6 

15 

3 

5—10        „  ...   

4 

2 

2 

10—15  „   

8 

2 

1 

15—20  „   

22 

20—25  .,   

60 

3 

2 

25—35  .,   

155 

3 

2 

35—45  „   

124 

1 

1 

45—55  „   

32 

1 

3 

55—65   

9 

1 

65  and  upwards, 

4 

All  ages,  ... 

424 

27 

15 

The  widespread  distributiou  of  the  infection,  and  the  extent  to  which 
re-vaccination  was  resorted  to,  afforded  an  opportunity  of  observing  the  behaviour 
of  the  disease  in  one  section  of  the  population  which,  in  the  course  of  the  outbreak, 
gradually  increased  until  it  comprised  almost  60  per  cent,  of  the  whole.  This 
section  comprised  those  persons  who  were  successfully  re-vaccinated  before  they 
were  exposed  to  infection  between  January,  1901,  and  May,  1902.  It  may  be 
represented  as  increasing  by  fortnightly  drafts  obtained  from  the  section  who  were 
not  re-vaccinated,  as  is  shown  in  the  following  Table  (p.  46). 

In  respect  of  susceptibility  and  the  opportunities  of  exposure  to  infection, 
there  is  nothing  to  distinguish  between  these  two  sections  here  shown  save  the 
solitary  circumstance  of  successful  re-vaccination,  and  the  contrast  presented  by  the 
uniform  absence  of  cases  from  the  re-vaccinated  section  requires  no  elaboration. 

*  During  the  period  of  recrudescence  11  cases  were  admitted  with  a  history  of  siiccessful  re- vaccina- 
tion before  infection,  and  in  10  of  these  the  statement  of  the  patient  was  supported  by  the  presence  of 
distinguishable  marks.  The  intervals  elapsing  between  re-vaccinatfon  and  attack  were  resoectively 
3,  3,  4,  7,  8,  9,  12,  26,  32,  40,  and  55  years. 


■i6 

Table  YIII. — Glasgow. — Smallpox,  1901-1902. — Un-revaccinated  and  Re-vaccinated 
Population  in  each  Fortnight,  with  the  Cases  of  Smallpox  occurring  in 
EACH  Class. 


1901. 

Not  Recently  Re-vacoinated. 

Recently  Re-vaccinated. 

Population. 

Cases 
Registered.* 

Population. 

Gases 
Registered. 

January 

12th,  

675,887 

26th,  

4,81o 

1,0  / 1 

February 

9th,  

671,025 

•1  A.I 

202 

A    O  J? 

4,862 

23rd,  

oo4,213 

i21 

A  1    £*f7  A 

4l,o74 

March 

9  th,  

556,561 

23rd,  

518,426 

lol 

157,461 

April 

6th,  

474,Da4 

y  J 

OAT   1  OQ 

n 

20th,  

429, OOD 

d7 

24D,o3i 

May 

4th,  

384,371 

28 

291,516 

51 

18th,  

366,125 

T  O 

18 

309,762 

June 

1st,  

352  633 

t/  w  J  \j  tj 

11 

323,254 

5) 

15th,  

2 

328,110 

29th,  

Q 

O 

July 

13th,  

1 

3y4,020 

November  1 6th,  ... 

1 

)) 

30th,  

279,232 

5 

39  b,bo5 

December  14th,  ... 

279,020 

4 

39b, 867 

28th,  

278,796 

397,091 

1902. 
J  anuary 

11th,  

278,623 

28 

397,264 

25th,  

278,152 

23 

397,735 

February 

8th,  

277,653 

23 

398,234 

)) 

22nd,  

277,134 

147 

398,753 

March 

8th,  

276,033 

92 

399,854 

)> 

22nd,  

274,611 

85 

401,276 

April 

5th,  

272,694 

36 

403,193 

)) 

19th,  

271,619 

15 

404,268 

May 

3rd,  

27L032 

10 

404,855 

*  The  Cases  under  five  years  have  not  been  excluded  from  these  figures,  because  their  allocation 
through  the  various  fortnights  would  have  been  difficult,  and  their  inclusion  is  unimportant.  In  the 
1900-1901  part  of  the  outbreak  these  numbered  60,  54  of  whom  (including  30  cases  occurring  under 
one  year)  were  unvaccinated  primarily. 


47 

Expenditure  on  Re-vaccination. 

From  1st  June,  1900,  till  1st  March,  1902,  the  amount  expended  in  connection 
with  re-vaccination  was  as  follows : — 


Calf  Lymph,    £4,570 

Fees  to  Practitioners,    22,776 

Do.    Extra  Vaccination  Staff,  &c.,      ...        ...        ...  4,177 

Do.    Prison  and  Parish  Surgeons,        ...        ...        ...  713 


Total,   £32,236 


49 

CHARTS  OF  SICKENING. 

These  charts  have  been  constructed  after  careful  enquiry  into  the  dates  of 
sickening  of  the  cases  occurring  during  the  epidemic  period  and'^during  the  whole 
period  of  recrudescence.  The  interval  of  declining  prevalence  which  occurred  in 
the  middle  of  the  epidemic  period  is  shown  by  a  depression  beginning  on  the  1st 
and  extending  to  19th  February. 

The  secondary  wave  of  prevalence,  which  reached  its  acme  on  1st  February, 
is  obviously  definitely  related  to  the  earlier  prevalence  of  17th  January,  but  the 
recurring  increases,  which  began  on  19th  February,  and  reached  their  maximum 
on  2nd  March,  have  a  less  tangible  relationship  with  the  amount  of  infection 
which  was  distribiited  by  the  cases  sickening  about  1st  February. 

The  rapid  recurrence,  also,  of  the  elevations  of  26th  February  and  2nd 
March  are  in  striking  contrast  with  the  uniform  rise  and  fall  of  the  waves  of  l7th 
January  and  1st  February.  They  suggest  the  difference  between  a  source  of 
infection  in  somewhat  continuous  operation  and  one  in  which  the  discharge  is 
periodic.  The  disti'ibution  in  these  later  prevalences  was  pretty  general,  and 
the  following  contrast  between  the  proportions  in  corresponding  fortnights  in  the 
Eastern  and  Southern  Districts  is  important  in  this  respect  that  the  Southern 
District  is  beyond  Hospital  influence,  and  yet  a  recurring  prevalence  late  in 
February  was  also  apparent  there:  — 

Proportion  of  Total  Attacks  in  Eastern  and  Southern  Districts  occurring 
IN  Several  Fortnights  of  the  Epidemic  Period. 

Eastern  Cases,  863.  Southern  Cases.  200. 

26th  January,         =        29-7  per  cent.  =  26-0  per  cent. 

9th  February,       =        12-1       .,  =  18-5  „ 

23rd       „             =         7-8      „  =  8-5 

9th  March,           =       254      „  =  13-0 

23rd      „               =       12-6       .,  =  8-0  „ 

MAPS. 

Little  need  be  added  by  way  of  a  special  description  of  the  accompanying 
maps,  I.  to  YII.  In  them  the  administrative  divisions  of  the  City  are  contained 
within  the  thick,  and  the  sub-districts  within  the  thin  red  lines.  The  former 
are  referred  to  in  the  text  as  Eastern,  Central,  Western,  Northern,  North- 
Western,  Southern,  and  South-Suburban ;  while  the  sub-districts  are  numbered 
consecutively,  a  few  being  distinguished  by  letters.  Save  where  otherwise 
stated,  the  maps  are  constructed  on  the  number  of  cases  registered  fortnightly, 
but  some  exceptions  occur  where  the  arrangement  is  according  to  periods  of 
sickening.  Where  it  was  wished  to  distinguish  between  the  areas  involved  in 
successive  fortnights  a  distinguishing  colour  has  been  used.  The  situation  of  the 
Hospital  is  indicated  by  a  red  cross,  and  the  circles  surrounding  it  are  drawn  with 
radii  respectively  of  \  mile,  \  mile,  1  mile,  and  11  miles. 

In  Map  1.  it  will  be  seen  that  during  the  early  weeks  of  the  invasion  of  the 
disease  the  direction  in  which  dissociated  cases  tended  to  spread  was  northerly, 
whereas  in  the  fortnights  ending  2nd,  16th,  and  30th  June  there  was  a  quite 
definite  distribution  of  cases  in  the  Eastern  Division  (see  Map  IL). 

In  the  several  fortnights  shown  on  this  map  the  sicknesses  occurred  on  the 
following  dates,  and  it  may  be  observed  regarding  the  sicknesses  occurring 
towards  the  end  of  May  that  the  wind  was  continuously  from  the  east  between 
the  7th  and  13th  of  the  month,  south-east  on  the  6th,  and  north-east  on  the  14th. 


50 


On  all  the  other  days,  save  tlie  last  two,  tlie  direction  varied  to  the  north  or  south 
of  west.    From  30th  May  to  4th  June  the  wind  was  east. 


Record 

OF  Daily 

SiCKENINGS  IN  EASTERN  DISTRICT— 

May  and 

June,  1900. 

Fortnight 

ending 
2nd  June. 

Number 
Sickening. 

ending 
16th  June. 

Number 

.^1  pIt  pm  n  cr 

Fortnight 

ending 
30th  June. 

Number 

24th  May,  - 

2 

3rd  June, 

- 

17th  June, 

3 

25th  „ 

4th  „ 

2 

18th 

2 

26th  „ 

5th  ., 

19th 

Ji 

1 

27th    „  - 

1 

6th  „ 

1 

20th 

3 

2c5th  „ 

7th  „ 

21st 

2 

29th  „ 

2 

8th  „ 

4 

22nd 

2 

30th  „ 

3 

9th  „ 

2 

23rd 

?) 

4 

31st  ,, 

4 

10th  „ 

-  -4 

24th 

1 

1st  June,  - 

2 

nth  „ 

3 

25th 

4 

2nd  ,, 

2 

12th  „ 

3 

26th 

!J 

13th  „ 

5 

27th 

3J 

14th  „ 

3 

28th 

)  J 

15th  „ 

2 

29th 

16th  „ 

30th 

)J 

16  29  22 


During  the  weeks  of  July  and  August  cases  were  recorded  in  the  situations 
already  indicated  in  Map  IL,  but  also  extending  eastwards  from  Parkhead  Cross 
along  Westmuir  Street  and  Great  Eastern  Road. 

Map  III.  shows  the  cases  recorded  in  the  fortnights  ending  1st,  15th,  and 
29th  December,  1900,  and  12th  January,  1901,  and  in  respect  of  numbers  affords 
a  striking  contrast  with  those  occurring  in  the  following  fortnight,  shown  in  Map  IV. 

In  Map  V.  the  distribution  of  the  cases  forming  the  major  part  of  the  second 
rise,  culminating  on  March  2nd,  are  shown ;  and  if  any  distinction  is  to  be  drawn 
between  this  and  that  shown  on  Map  IV.,  it  might  be  said  that,  while  in  the 
earlier  period  the  cases  in  the  Eastern  District  tend  to  aggregation  along  main 
lines  of  traffic,  the  distribution  in  the  second  fortnight  is  more  uniformly  spread 
over  the  intervals  between  these  lines. 

Map  VI.  covers  the  whole  period  of  recrudescence  until  1st  May,  1902.  The 
distribution  of  the  earlier  cases  between  November  and  February  is  indicated  by 
blue  dots,  and  one  of  the  most  striking  episodes  in  the  recurrence  is  shown  on 
Map  VII.,  when  in  the  fortnight  ending  22nd  February  the  whole  character  of 
the  recrudescence  became  altered,  and  we  had  repeated,  on  lines  very  similar  to 
those  of  the  major  outbreak,  an  epidemic  activity  which  in  numbers  amounted  to 
quite  one-third  of  the  volume  occurring  in  corresponding  months  of  1901. 

Some  reference  has  already  been  made  to  the  prevailing  meteorological 
conditions  in  May,  1900,  and  more  complete  details  will  be  found  in  Appendices. 
The  annexed  summaries  of  the  conditions  prevailing  during  several  months  when 
the  disease  was  most  active  are  also  by  Professor  Becker.  It  may  be  observed 
with  regard  to  the  increased  prevalence  late  in  February,  1901,  that  on  the  2nd 
and  13th  only  was  the  wind  easterly,  while  the  increase  began  on  the  19th. 

A.  K.  CHALMERS,  M.D. 

Sanitary  Chambers, 

Glasgow,  May,  1902. 


51 


APPENDICES. 


Meteorological  Observations  taken  at  Glasgow  Observatory 
DURING  May,  1900. 


Day  of 

the 
Month. 

Humidity 
per  cent. 

MiDXIGH" 

Wind. 

r  TO  jMidnight. 
Rain. 

Remarks. 

9  a.m. 

9  p.m. 

Genercil 
Direction. 

Inches. 

Hours. 

1 

60 

71 

W. 

•01 

1 

Slight  rain  in  morning.    Solar  halo  at 

7  p.m.    Cloudy  and  dull. 

84 

75 

s.w. 

•08 

5 

Heavy  rain  in  morning.    Cloudy  and 

fine. 

3 

76 

80 

s.w. 

•21 

14 

Cloudy  and  heavy  showers. 

4 

83 

74 

s. 

■20 

5 

Heavy  rain  in  morning.  Overcast 

and  squally. 

5 

88 

70 

s. 

■07 

6 

Rain  in  morning.    Cloudy  and  fine. 

6 

63 

93 

S.E. 

•20 

7 

Morning  cloudy.    Rain  afternoon  and 

evening. 

7 

93 

86 

E. 

•18 

10 

Rain  in    morning.     Dull.  Evening 

cloudy. 

8 

73 

81 

E. 

•02 

2 

Cloudy.    Slight  rain  in  evening. 

9 

69 

79 

E. 

•13 

5 

Heavy   rain    in    morning.  Cloudy. 

Evening  dull. 

10 

72 

74 

E. 

Cloudy  and  dull. 

11 

74 

74 

E. 

Generally  overcast. 

12 

76 

72 

E. 

•09 

8 

Rain  in  morning.    Cloudy  and  dull. 

13 

62 

74 

E. 

Cloudy  and  dull. 

14 

58 

75 

N.E. 

Cloudy  and  fine. 

15 

60 

69 

W. 

Clear  and  fine. 

16 

49 

70 

N.W. 

Clear  and  fine. 

17 

63 

69 

N.W. 

Cloudy  and  fine. 

18 

Ot 

0  J 

N. 

Cloudy  and  dull. 

19 

65 

74 

W. 

Cloudy  and  fine. 

20 

62 

75 

w. 

Cloudy  and  dull. 

21 

83 

94 

•42 

10 

Overcast  and  rain. 

22 

77 

83 

s.w. 

•17 

12 

Cloudy  and  heavy , showers. 

23 

85 

89 

s.w. 

•07 

3 

Rain  morning  and  afternoon.  Cloudy. 

24 

59 

78 

w. 

Cloudy  and  fine. 

25 

68 

87 

w. 

•01 

1 

Slight  rain  in  morning.  Cloudy. 

26 

72 

79 

s.w. 

•03 

4 

Cloudy  and  dull.    Rain  in  evening. 

27 

81 

92 

s.w. 

•25 

13 

Overcast  and  rain. 

28 

84 

80 

w. 

■02 

3 

Rain   in   morning.     Squally.  Dull 

29 

66 

and  cloudy. 

73 

N.W. 

Clear  and  fine. 

30 

66 

74 

E. 

Clear  and  fine.    Evening  dull. 

31 

77 

80 

E. 

Dull  and  overcast. 

52 


Meteorological  Observations  taken  at  Glasgow  Observatory 
DURING  June,  1900. 


Day 
of  the 
Month. 



Humidity 
per  cent. 

MiDNiaHT  TO  Midnight. 

Wind. 

Rain. 

Remarks. 

9  a.m. 

9  p.m. 

General 
Direction. 

Inches. 

Hours. 

1 

2 

79 

80 

83 
73 

E. 
E. 

Morning  and  evening  dull.  Afternoon 
clear. 

Morning  dull.    Clear  and  fine. 

3 

68 

63 

E. 

Clear  and  fine. 

4 

72 

87 

E. 

Clear  and  fine.    Evening  cloudy. 

5 

88 

79 

N.E. 

Cloudy  and  dull. 

6 

79 

87 

KE. 

Cloudy  and  dull. 

7 

8 

86 
85 

91 
81 

E. 
E. 

•18 
•01 

6 
2 

Rain  morning  and  afternoon.  Cloudy, 
thunder  and  lightning  at  3.30  p.m. 
Dull,  and  evening  cloudy. 

9 

94 

86 

S. 

•14 

6 

Overcast.    Drizzling  rain. 

10 

66 

74 

S. 

Cloudy  and  dull. 

11 
12 
13 
14 

71 

80 
86 
77 

83 
92 
90 
75 

w. 

E. 
E. 

s.w.  _ 

•02 
•14 
•51 

1 
7 

12 

Cloudy.      Shower   about    7.20  p.m. 

Thunder  at  8  p.m. 
Thunderstorm  and  rain  morning  and 

{^"STt^Yi in  rr         1  In  1 1 
xj  V  t;±iiJLl^.        .1 J  LLIi. 

Cloudy.    Thunderstorm  morning  and 

afternoon.    Heavy  rain. 
Cloudy  and  fine. 

15 

63 

87 

S.E. 

Cloudy  and  dull. 

16 

74 

89 

w. 

•18 

3 

Cloudy.    Rain  at  night. 

17 

75 

76 

w. 

•08 

9 

Rain  in  morning.    Clear  and  fine. 

18 

69 

78 

s.w. 

Cloudy.    Evening  dull. 

19 
20 
21 

22  - 
23 

87 
86 
71 
69 
65 

77 

85 
91 
82 
73 

s. 

s.w. 
w. 
w. 
w. 

■29 
•40 
•39 
•23 

8 
9 

4 

Rain  morning  and  afternoon.  Over- 
cast. 

Heavy  rain  in  morning.  Thunder  in 
afternoon.    Slight  rain  at  10  p.m. 

Cloudy  and  dull.  Heavy  rain  and 
thunder  in  afternoon. 

Rain  in  morning.  Thunder  at  noon. 
Cloudy. 

Clear  and  fine. 

24 

81 

95 

E. 

1^36 

16 

Overcast  and  heavy  rain. 

25 

68 

M 

81 

N.E. 

■04 

3 

Rain  in  morning.    Cloudy  and  dull. 

26 

68 

84 

N.W. 

Overcast.    Evening  cloudy. 

27 

71 

77 

W. 

Cloudy  and  fine. 

28 
29 

59 
73 

74 

95 

S.W. 

s.w. 

•01 
•16 

1 
10 

Morning  fine.     Dull.     Slight  rain  at 
night. 

Rain  morning  and  evening.  Overcast. 

30 

85 

94 

w. 

•20 

8 

Cloudy.    Rain  at  night. 

53 


Meteorological  Observations  taken  at  Glasgow  Observatory  from 
26th  December,  1900,  to  31st  January,  1901.^ 


Day  of 

the 
Month. 

Humidity 
per  cent. 

Midnight  to  Midnight. 

Wind. 

Rain. 

9  a.m. 

9  p.m. 

General 
Direction. 

Inches. 

Honrs. 

oa 
Zo 

o4 

88 

s.w. 

•m 

1 

z7 

QK 

yo 

85 

£j. 

OO 

la 

28 

DO 

-IN .  w . 

n 
1 

29 

85 

88 

W  . 

■06 

2 

Q  A 

oU 

yo 

82 

E. 

01 

1  / 

Q  1 

ol 

OD 

81 

N.E. 

Jan. 

1 

86 

90 

ft.  W  . 

•13 

7 

9 

94 

S.W. 

uo 

A 

Q 

o 

a  o 

86 

to.  W . 

4 

yo 

79 

ft.  vV. 

5 

OD 

82 

b.hi. 

o 

73 

69 

Hi. 

n 
1 

82 

84 

E. 

Q 

o 

89 

85 

E. 

•07* 

5 

Ci 

y 

OO 

82 

E. 

10 

yb 

93 

E. 

UO 

Q 

0 

11 

96 

91 

Til 

hi. 

•12 

6 

12 

92 

89 

E. 

1  o 

85 

79 

E. 

1  A 

81 

66 

Jsr.E. 

15 

74 

68 

N.E. 

16 

79 

91 

KE. 

17 

91 

85 

S.W. 

•01 

5 

18 

92 

93 

S.W. 

•13 

5 

19 

96 

92 

N.E. 

•39 

11 

20 

81 

82 

W. 

•13 

10 

21 

87 

84 

w. 

•02 

3 

22 

95 

81 

w. 

•13 

10 

23 

83 

77 

S.W. 

24 

93 

91 

S.W. 

•10 

8 

J,0 

83 

77 

w. 

•41* 

12 

26 

78 

98 

w. 

•26* 

12 

27 

67 

93 

N.W. 

•30 

18 

28 

100 

86 

w. 

•17t 

5 

29 

90 

75 

N.W. 

•Olt 

5 

30 

73 

73 

N.W. 

31 

72 

72 

N.W. 

Remarks. 


Dull  and  cloudy. 
Overcast  and  rain. 

Rain  morning  and  afternoon.  Squally. 
Slight  showers    in  morning.  Fine. 

Haze  and  sleet  at  night. 
Overcast  and  rain.    Cloudy  at  night. 
Dull  and  overcast. 


Cloudy  and  showery. 

Rain  in  morning.    Cloudy.    Fog  at 

night. 
Dull  and  hazy. 
Dull  and  overcast. 
Cloudy  and  dull.    Hazy  at  night. 
Hoar  frost  in  morning.    Cloudy  and 

dull. 

Dull  and  overcast. 

Dull  and  overcast.    Snow  in  forenoon. 
Cloudy  and  misty.   Hoar  frost  at  night. 
Overcast.    Rain  in  afternoon. 
Dull  and  hazy.    Rain  afternoon  and 

evening. 
Cloudy  and  hazy. 
Dull  and  overcast. 
Cloudy  and  hazy. 

Cloudy  and  hazy  in  morning.  After- 
noon and  evening  clear. 
Cloudy  and  dull. 

Slight  rain  in  morning.  Cloudy. 

Rain  morning  and  afternoon.  Cloudy. 

Overcast  and  rain.    Evening  cloudy. 

Overcast,  squally  and  showery. 

Overcast  and  rain  in  forenoon.  Cloudy 
and  squally  in  evening. 

Squally  and  rain  morning  and  after- 
noon.   Evening  cloudv. 

Dull. 

Dull  and  showery.  Squally  in  evening. 
Rain  in  morning.    Squally  and  cloudy. 

Showers  of  snow. 
Snow,   2^  inches  deep,  in  morning. 

Dull.  Rain  in  afternoon  and  evening 
Squally,  cloudy,  showers  of  hail,  rain, 

and  snow. 
Cloudy,  and  snow  showers,  2|  inches 

deep.    Lunar  corona  at  6  p.m. 
Cloudy  and  dull. 

Cloudy  and    dull.    Lunar  halo  and 

corona  at  7.30  p.m. 
Clear  and  fine.    Lunar  corona  at  9.15 

p.m.,  and  halo  at  10.30  p.m. 


Rain  and  Melted  Snow. 


t  Melted  Snow. 


54 


Meteorological  Observations  taken  at  Glasgow  Observatory 
DURING  February,  1901. 


Day  of 
the 

J.TXUU  Lll* 



Humidity 
per  cent. 

MiDNIGHl 
Wind. 

TO  Midnight. 
Rain. 

Remakks. 

9  a.m. 

9  p.m. 

General 

Inches. 

Hours. 

1 

78 

96 

W. 

•05 

5 

Dull.    Rain  in  afternoon. 

2 

O  i 

80 
ou 

N.E. 

Cloudy  and  dull. 

3 

89 

74 

N.W. 

Clear  and  fine. 

4 

90 

73 

isr.w. 

•14* 

4 

Wnriw    1  inr'M  riApn  m  TAFPTinriTi  linil 

Evening  cloudy. 

5 

73 

79; 

N. 

Clear  and  fine. 

6 

62 

68 

N. 

Clear  and  fine.    Evening  overcast. 

w. 

2 

XVdrllX  111    1 1  n  1 1  1 1  1  1 1  V          WIUULI^    CLXILL  LlUll. 

Q 
O 

86 

88 

w 

vv  . 

Uull  and  overcast.    Juvening  clear. 

Q 

v 

91 

86 

w 

vv  . 

Olear  and  tine,    xuvening  xiazy. 

10 

93 

88 

w. 

Morning  misty.     Cloudy.  Evening 

dull. 

11 

53 

79 

N. 

Clear  and  fine. 

12 

88 

77 

W. 

Cloudy  and  fine. 

13 

75 

79 

E. 

•04-* 

A 

t: 

Snow  in  morning.    Cloudy.  Evening 

clear. 

14 

72 

N.W. 

J-X^JCtl   llUoU  cfcllU                      '  '"-^           o'       v^lCdl . 

Evening  hazy. 

79 

89 

vv . 

Hoar   frost   and   haze   in  morning. 

Clear  and  fine. 

16 

91 

59 

N.W. 

Clear  and  fine. 

17 

70 

79 

N. 

Cloudy  and  dull. 

18 

91 

92 

W. 

Cloudy  and  dull. 

19 

99 

85 

E. 

Morning  foggy.    Cloudy  and  misty. 

20 

91 

87 

W. 

Cloudy  and   misty.     Thick  fog  at 

intervals.    Hoar  frost  at  night. 

21 

88 

W. 

Hoar  frost  and    haze  morning  and 

evening.    Cloudy.    Evening  clear. 

22 

92 

86 

w. 

Cloudy  and  dull. 

23 

82 

90 

w. 

Dull  and  overcast 

24 

90 

99 

w. 

■53 

17 

Overcast  and  rain. 

•2b 

96 

90 

E. 

•13 

20 

Overcast  and  rain. 

26 

91 

89 

S.E. 

•50 

18 

Overcast  and  rain. 

27 

95 

74 

E. 

•11 

8 

Rain  in  morning.    Cloudy  and  dull. 

28 

85 

88 

E. 

Dull  and  overcast. 

*  Melted  Snow. 


55 


Meteorological  Observations  taken  at  Glasgow  Observatory  from 
16th  January  till  28th  February,  1902. 


Day 

01  Tine 
Month 

Humidity 
per  cent. 

Midnight  to  Midnight. 

>- 

X  b  ilj  iVl  ii.  A  A.  O  > 

Wind. 

Rain. 

9  a.m. 

9  p.  m. 

General 
Direction. 

Inches. 

Hours. 

Jan. 

16 

Q  A 

o4 

y  J 

w. 

Dull. 

17 

O  X 

00 

88 

W. 

Overcast.    Cloudy  at  night. 

18 

97 

oU 

C!  WT 
b.  W  . 

Fog  in  morning.  Dull. 

19 

yo 

o7 

CI  ^TT 

0 

Dull.    Squally  and  rain  at  night. 

20 

Q/f 

yo 

vv. 

4y 

1  7 

Heavy  rain  m  morning.    Dull,  blight 

I'ain  at  night. 

21 

yb 

A  PC 

yo 

b.  W . 

oy 

90 

Overcast  and  rain. 

22 

y  1 

Q7 

y  / 

b.  W  . 

•m 

Dull.     Slight   drizzle   morning  and 

night. 

23 

00 

i  0 

b.  W  . 

•A/) 
U4 

0 

Drizzle  in  morning.   Dull.   Kain  alter 

11.20  p.m. 

24 

94 

80 

WT 

•47 

15 

Overcast  and  rain.    Showers  of  snow 

afternoon  and  night. 

25 

64: 

w. 

.AO 

1 

Slight   snow   in   morning.  Cloudy. 

Evening  clear. 

26 

Ob 

/  4 

■\T  WT 
JN.  W. 

Clear  and  line.    Evening  dull. 

27 

b  1 

yo 

Jcj. 

Dull.    Snow  after  2  p.m. 

28 

Q  Q 
OO 

Do 

JN  . 

10 

1  o 

Snow  in  morning.    Cloudy.  Evening 

clear.    Snow  lying  2|  inches  deep. 

29 

00 

"VT  WT 

JN .  W. 

•AQ 

uy 

0 

Snow  in  morning.    Clear  and  fine. 

Snow  lying  5i  inches  deep. 

30 

1  on 

00 

t?  ^ 

WJ 

Hoar  frost  and  fog. 

31 

oO 

Hi. 

Hoar  frost  and  fog  in  morning.  Even- 

ing clear.    Aurora  about  11  p.m. 

Feb. 

1 

00 

T? 
Ih. 

Hoar  irost  and  sno'w  lying  in  morning. 

Fine.    Evening  dull. 

2 

85 

89 

ill. 

•01 

3 

Dull.    Slight  rain  at  night. 

3 

OO 

/  0 

E. 

Slight  rain  in  morning.    Cloudy  and 

A  11 
dull. 

4 

oO 

Hi. 

Morning  hazy.     Dull  and  overcast. 

5 

/  b 

7Q 

<  y 

O  TXT 
b.  W  . 

Hoar  frost  in  morning.   Dull  and  hazv. 

6 

QA 

oU 

QQ 

yo 

Q  WT 
b.  W . 

(JO 

9 

Overcast.    Rain  between  5  and  7  p.m. 

Evening  cloudy. 

7 

U  _/ 

JN  .ili. 

Hoar  frost.  Cloudy  and  hazy.  Evening 

dull. 

8 

T  Q 
/  O 

b  1 

.A  ^  * 

U4^ 

Q 

o 

Slight    snow    morning    and  night. 

Cloudy. 

9 

oO 

Ob 

WT 

Snow    lying   ^    inch    deep.  Fine. 

TT'             '                   1                       A                             1           J  O 

xiivening   clear.    Aurora   about  8 

10 

(  0 

/  4 

WT 

p.m. 

Morning  hazy.    Clear  and  fine. 

11 

DO 

bO 

AT  WT 

JN .  W . 

Hoar  frost    and    haze    in  morning. 

Clear  and  fine. 

12 

0  J 

7  ^ 
/  4 

WT 
W. 

0/* 

o 
O 

Snow  in  morning,  1  inch  deep.  Clear 

and  fine. 

13 

1  on 

70 
1  _j 

b. 

Hoar  frost  in  morning.   Foggy.  Snow 

lying. 

14 

ob 

7i? 

/  b 

vv  . 

jNIorning  dull  and  snow  lying.  Cloudy. 

Lunar  halo  and  corona  at  7  p.m. 

15 

00 

00 

b.  W. 

Hoar  frost  and  fog  in  morning.  Fine. 

Evening  dull. 

16 

oO 

o 

b. 

Dull  and  overcast. 

17 

53 

70 

TP 
Jli. 

Dull  and  hazy. 

18 

68 

95 

E. 

Morning  hazy.    Fine.    Evening  dull. 

19 

85 

85 

E. 

Dull  and  overcast. 

20 

86 

96 

S.E. 

Dull  and  overcast. 

21 

87 

87 

S. 

Dull  and  overcast. 

22 

88 

89 

S.E. 

•16 

5 

Overcast.    Rain  after  8  p.m. 

98 

93 

E. 

•39 

11 

Morning  showery.    Overcast.  Heavy 

rain  at  night. 

24 

84 

91 

E. 

•34 

13 

Overcast  and  rain. 

25 

94 

90 

N.E. 

•05 

5 

Rain  in  morning.    Cloudy  and  dull. 

26 

80 

77 

E. 

Cloudy.  Breezy. 

27 

90 

87 

E. 

■oVt 

6 

Snow  in  morning.   Afternoon  showery. 

Dull. 

28 

91 

97 

N.E. 

•30 

12 

Overcast  and  rain.    Evening  cloudy. 

*  Melted  Snow.  f  Rain  and  Melted  Snow. 


56 


MAY,  1900. 

Temperature,  &c.,  as  depending  on  the  Direction  of  the  Wind. 


Direction. 

Days. 

Mean 
Temp. 

Mean 
Max. 
Temp. 

Mean 
Min. 
Temp. 

Total 
Sun- 
shine. 

Average 
Daily 
Sun- 
shine. 

Total 
Rain. 

Average 
Daily 
Rain. 

Hourly 
Velocity  of 
Wind. 

Deg. 

Deg. 

Deg. 

Hours. 

Hours. 

Inches. 

Inches. 

Miles. 

North,   

1 

47-8 

55 

42 

4 

4-0 

0-00 

0-00 

8-0 

North-East,   

1 

46-4 

56 

38 

9 

9-0 

0-00 

0-00 

7-0 

East,   

9 

47-8 

54 

42 

33 

3-7 

0-42 

0-05 

9-7 

South-East,  ...   

1 

48-9 

58 

42 

4 

4-0 

0-20 

0-20 

10-0 

South, 

3 

50-7 

55 

46 

8 

2-7 

0-61 

0-23 

17-3 

South-West,   

6 

51-2 

57 

46 

18 

3-0 

0-81 

0-14 

13-8 

West,   

7 

50-2 

58 

44 

44 

6-3 

0-04 

0-01 

11-3 

North- West,   

3 

54-0 

64 

45 

33 

11-0 

0-00 

0-00 

9-3 

JUNE,  1900. 

Temperature,  (fee.  as  depending  on  the  Direction  of  the  Wind. 


Direction. 

Days. 

Mean 
Temp. 

Mean 
Max. 
Temp. 

Mean 
Min. 
Temp. 

Total 
Sun- 
shine. 

Average 
Daily 
Sun- 
shine. 

Total 
Rain. 

Average 
Daily 
Rain. 

Average 
Hourly 
Velocity  of 
Wind. 

North,   

0 

Deg. 

Deg. 

Deg. 

Hours. 

Hours. 

Inches. 

Inches. 

Miles. 

North-East,   

3 

54-5 

66 

47 

9 

3-0 

0-04 

0-01 

8-7 

East, 

9 

54-8 

65 

49 

50 

5-6 

2-20 

0-24 

9-9 

South-East, ... 

1 

58-8 

66 

48 

1 

1-0 

0-00 

0-00 

6-0 

South, 

3 

57-5 

65 

52 

5 

1-7 

0-43 

0-14 

11-0 

South-West,   

5 

56-9 

64 

51 

25 

5-0 

0-57 

0-11 

8-8 

West,   

8 

57-4 

65 

52 

56 

7-0 

MO 

0-14 

8-4 

North-West,   

1 

55-4 

60 

50 

4 

4-0 

0-00 

0-00 

9-0 

57 


DECEMBER,  1900. 
Temperature,  &c.,  as  depending  on  the  Direction  of  the  Wind. 


Direction. 

Days. 

Mean 
Temp. 

Mean 
Max. 
Temp. 

Mean 
Min. 
Temp. 

Total 
Sun- 
shine. 

Average 
Daily 
Sun- 
shine. 

Total 
Rain. 

Average 
Daily 
nam. 

Average 
Hourly 
Velocity  of 
Wind. 

North,   

0 

Deg. 

Deg. 

Deg. 

Hours. 

Hours. 

Inches. 

Inches. 

Miles. 

North-East,   

3 

39-9 

42 

38 

0 

00 

1-45 

0-48 

8-0 

East,   

4 

40-7 

43 

39 

0 

0-0 

M6 

0-29 

8-8 

South-East,  ... 

2 

42-4 

44 

41 

0 

00 

0-40 

0-20 

7-5 

South, 

1 

41'7 

49 

39 

0 

0-0 

0-06 

0-06 

7-0 

South-West, 

18 

4G-7 

49 

43 

5 

0-3 

3-71 

0'21 

20-0 

West,   

2 

39-8 

44 

37 

5 

2-5 

0-43 

0-22 

16-0 

North-West,   

1 

42-5 

45 

41 

0 

0-0 

013 

013 

19-0 

JANUARY,  1901. 
Temperature  &c.,  as  depending  on  the  Direction  op  the  Wind. 


Direction. 

Days. 

Mean 
Temp. 

Mean 
Max. 
Temp. 

Mean 
Min. 
Temp. 

Total 
Sun- 
shine. 

Average 
Daily 
Sun- 
shine. 

Total 
Rain. 

Average 
Daily 
Rain. 

Average 
Hourly 
Velocity  of 
Wind. 

North,   

0 

Deg. 

Deg. 

Dog. 

Hours. 

Hours. 

Inches. 

Inches. 

Miles. 

North-East,   

4 

38-6 

43 

35 

0 

0-0 

0-39 

0-10 

10-3 

East,   

8 

37-0 

39 

34 

2 

0-3 

0-24 

0-03 

10-1 

South-East,  ... 

1 

38-G 

43 

34 

0 

0-0 

0.00 

0-00 

9  0 

South, 

0 

South- West, 

8 

42-1 

45 

39 

5 

0-6 

0-40 

0-05 

IM 

West,   

6 

39-1 

45 

35 

2 

0-3 

1-12 

0-19 

18-2 

North-West,   

4 

36-6 

41 

32 

10 

2-5 

0-31 

0-08 

15-8  j 

58 


FEBRUARY,  1901. 
Temperature,  &c.,  as  depending  on  the  Direction  of  the  Wind. 


Direction. 

Days. 

Mean 
Temp. 

Mean 
Max. 
Temp. 

Mean 
MiD. 
Temp. 

Total 
Sun- 
shine. 

Average 
Daily 
Sun- 
shine. 

Total 

Average 
Daily 
Rain. 

Average 
Hourly 
V^elocity  of 
Wind. 

North, 

4 

Deg. 
34-3 

Deg. 

38 

Deg. 
30 

Hours. 
20 

Hours. 
5-0 

Inches. 

0-00 

Inches. 
0-00 

Miles. 
7'3 

North-East,  ... 

•  1 

38-4 

42 

35 

3 

3-0 

0-00 

0-00 

8-0 

jiast;. 

0 

00  Zi 

A  9 

V  o 

U  Jo 

V  UD 

1  u 

iSouth-East,  ... 

1 

42-3 

44 

39 

0 

0-0 

0-50 

0-50 

9  0 

South, 

0 

South-West, 

0 

West,   

13 

37-9 

43 

33 

21 

1-6 

0-63 

0-05 

7-2 

North-West,   

4 

34-8 

40 

30 

14 

3-5 

0-14 

004 

6-5 

JANUARY,  1902. 
Temperature,  &c.,  as  depending  on  the  Direction  or 

THE  Wind. 

Direction. 

Days. 

Mean 
Temp. 

Mean 
Max. 
Temp. 

Mean 
Min. 
Temp. 

Total 
Sun- 
shine. 

Average 
Daily 
Sun- 
shine. 

Total 
Rain. 

Average 
Daily 
Rain. 

Average 
Hourly 
\'elocity  of 
Wind. 

North,  

1 

Deg. 
30-6 

Deg. 
37 

Deg. 
27 

Hours. 
1 

Hours. 
1-0 

Inches. 
0-15 

Inches. 
0-15 

Miles. 

7-0 

North-East, 

0 

East, 

3 

26-9 

32 

21 

0 

0-0 

0-00 

0-00 

o  o 

South-East, 

0 

South,         ...        ...  ... 

2 

33-6 

37 

30 

0 

0-0 

0-21 

0-11 

7-0 

South- West,   

9 

44-8 

47 

42 

0 

0-0 

1-28 

0-14 

16-2 

■  West,   

14 

40-3 

44 

36 

8 

0-6 

1-26 

0-09 

14-6 

North-West,   

2 

28-5 

33 

24 

10 

5-0 

0-09 

0-05 

10-5 

FEBRUARY,  1902. 
Temperature,  (fee,  as  depending  on  the  Direction  of 

THE  Wind. 

Direction. 

Days. 

Mean 
Temp. 

Mean 
Max. 
Temp. 

Mean 
Min. 
Temp. 

Total 
Sun- 
shine. 

Average 
Daily 
Sun- 
shine. 

Total 
Rain. 

Average 
Daily 
Rain. 

Average 
Hourly 
Yeiocity  of 
Wind. 

North, 

0 

Deg. 

Deg. 

Deg. 

Hours. 

Hours. 

Inches. 

Inches. 

Miles. 

North-East,   

3 

37 '3 

40 

35 

0 

0-0 

0-35 

0-12 

10-0 

East, 

12 

37-1 

40 

34 

8 

0-7 

0-85 

007 

10-9 

South-East, 

2 

38-3 

40 

37 

0 

0-0 

0-16 

0-08 

7-5 

South, 

3 

33-3 

37 

30 

0 

00 

0-00 

O'OO 

9-3 

South-West, 

3 

34-2 

38 

30 

3 

1-0 

005 

0-02 

8-3 

West,   

4 

31-2 

37 

25 

15 

3-8 

0-07 

002 

7-0 

North-West, 

1 

29-0 

33 

27 

7 

7-0 

0-00 

0-00 

7-0 

CHART,  A 


SMALLPOX  1901  .  (Epidemic  PeriodJ 
NUMBER  OF  CASES  SICKENING  DAILY. 


CHART,  B 

SMALLPOX  \^()\.-l(Recr,^esce^ceJ 

NUMBER  OF  CASES  SICKENING  DAILY. 


I90I 


OCT 

NO  V  EM  B  ER 

D 

f.CEM  B  ER 

 (*— 

w 

4 

5i6j7j8l9 

10 

12 

13 

14 

I5|I6 

17 

18 

m 

J2ib 

^4 

c  1 

2 

J 

+  56 

716:9  l|0JM2l3l4;iSll6il7 

22 

262 

7282 

9» 

il 

—i 

5- 

>— 

Itt 

A 

\ 

\ 

ii 

J  1  !  1 

It 

A 

 5— 

— n- 

I90E 


JANUARY 

FEBRUARY 

MARCH 

APRIL 

M 

A  Y 

J 

u 

N  E 

1  z  3 

4 

5 

67  8 

9 

laii 

I2il3!l4'l5|iei7 

l8;i320Zle223|24!25|26 

27 

28 

12980 

51 

l!2|3 

4  5 

e 

7 

8 

9 

10 

12 

14 

15 

16 

17 

IS 

21 

r> 

illi 

1 

4 

S 

6 

7 

a 

9 

la 

II 

13 

14 

15 

16 

17 

16119 

20 

21 

22 

2,1 

24 

25 

26 

27 

28 

29 

56 

31 

1 

2 

3 

4 

5 

6 

7 

S 

on 

12 

15 

1+ 

15 

16 

1? 

18 

19 

20 

21 

22 

23 

24 

25 

26 

29 

n 

SIT 

1 

z 

3 

4 

5 

6 

7 

8 

9 

10 

II 

E 

13 

14 

15 

I6|I7 

l« 

19 

20 

21 

2? 

2124 

2i 

2e 

27! 

28 

29 

1  (2 

5 

6 

7 

8 

9 

101 

12 

14 

15 

16 

17 

IS 

19 

20 

21 

22 

23 

2* 

25|2e 

2/ 

?B 

n 

30 

j— 56— 

■  i 

r 

50 

i  50 

'  1 

4'0  - 

t 

1 

- 

— J«- 

— 

 M 

- 

- 

} 

\ 

I 

V 

» 

-M- 

— ^e— 

#- 

7 

I 

t 
1^ 

- 

» 

f 

1 

1 — 5— 

— 6— 

* 

>.. 

4 

\ 

V 

• 

» 

■4 

• 

M 

^ 

>i 

1 

1 

—9— 

1  I 


COUNTY  OF  THE  Citt  OF  GlhSGOW 


J 


a  L. 


ft* 


EASTERN  CASES  SICKHNIKU. 
Fortnight  ending  2nd  June,  1900,  shown  in  black  dot«. 
„     IStli      „  ..  liUie 

.,  !•     30tli      ,,         ,,  ,  grtftu 


MAP  II. 


1 


I 


I 


"ME  CI 


LASGOW 


I  -  A  W 


V 


IlECKUDESCENCE  - 

Nuveniher,  1001,  to  Ut  XUy,  1003. 
Prior  to  Uth  February  shown  in  blue; 
otlierK  Bhowii  in  block. 


.  B  L. 


^  


MAP  VI. 


;. 


I 


GORPOKATION    OF  GLASGOW^ 


THIRTY-SIXTH    ANNUAL  REPORT 

ON  THE  . 

OPERATIONS    OF  THE 

SANITARY  DEPARTMENT 

/ 

OF    THE    CITY    OF  (GLASGOW, 

For  the  Year  ending  olsf  Decemljer,  1905, 

BY 

PETER    F  Y  F  E, 

CHIEF  SANITARY  INSPECTOR. 


Printed  for  the  Corporation  of  Glasgow  by 
ROBERT  ANDERSON,  14fi  WEST  NILE  STREET,  GLASGOW. 


SANITARY  ADMINISTRATION 


THE  CORPORATION  OF  THE  CTfY  OF  GLASGOW, 

BEING 

The  Local  Authority  of  saici  Citij  under  the  Public  Health 

'(Scotland)  Act,  1897. 

The  Honourable  WILLIAM  BILSLAND, 
Lord  Provost. 


The  Committee  on  Health  administers  all  jjortions  of  said  Act  relating  to 

"  General  Nuisances." 

Coiiweiier— Councillor  W.  FLEMING  ANDERSON. 
MEMBERS  OF  COMMITTEE   ON  HEALTH. 


Dean  of  Guild  (Robert  King). 

Bailie  Burrell. 

Bailie  Roderick  Scott. 


Councillor  MiCHAEL  J.  Connell, 
and 

Councillor  James  Henderson. 


And  the  following  Members  forming  the 


SUB-COMMITTEE  ON  HOSPITALS. 

The  Lord  Provost. 
Bailie  E.  Watson. 
Bailie  D.  Willox. 
Councillor  W.  F.  Anderson. 
Councillor  John  Battersby. 
Councillor  Hugh  Brechin. 
Councillor  James  Coutts. 
Councillor  James  Dick. 
Councillor  Garey. 
Councillor  Guest. 
Councillor  C.  R.  M'Lean. 
Councillor  Thomas  Paxton. 
Councillor  W.  F.  Russell. 
Councillor  Robert  Sloan. 
Councillor  James  Willock. 
Councillor  James  Steele,  Convener. 

Medical  Officer  of  Health — 
A.  K.  Chalmers,  M.D. 


SUB-COMMITTEE  ON  SANITARY  OFFICES, 
OPEN  SPACES,  &e. 

Bailie  D.  Willox. 
Treasurer  D.  M.  Stevenson. 
Councillor  W.  F.  Anderson. 
Councillor  John  Battersby. 
Councillor  Hugh  Brechin. 
Councillor  Charles  J.  Cleland. 
Councillor  Robert  Kirkland. 
Councillor  Alex.  B.  Kirkratrick. 
Councillor  Thomas  Paxton. 
Councillor  James  Steele. 
Councillor  James  W.  Stewart.' 
Councillor  Sutherland. 

Councillor  Wm.  Maclay,  Convener. 


Sanitary  Inspectoi' — 
Mr.  Peter  Fyfe. 


Bacteriologist — 

R.  M.  Buchanan,  M.B. 


Corporation  CJiemist  and  Analyst — 
CM.  Mr.  F.  W.  Harris,  F.C.S. 


Physician  Superintendents — 
Belvidere  Hospital — John  Brownlee,  M.D. 
Ruchill  iZ^ospitaZ— Alexander  Johnston,  M.D. 

Clerk  to  Local  Authority  under  tlie  Pahlic  Health  Act — 
Mr.  A.  W.  Myles,  Town-Clerk. 

Public  Vaccinator — Neil  Carmichael,  M.D. 
Procurator-Fiscal — George  Neilson,  LL.D. 

Treasurer  (Police  Department) — Mr.  James  D.  Borthwick. 


Sanitary  Chambers, 
23  Montrose  Street,  Glasgow. 


STAFF  OF  SANITARY  INSPECTOR'S  DEPARTMENT. 


INDOOR  STAFF. 


Public  Enquiry  Room, 
Chief  Inspector\i  Eoom ,  ... 
Central  District, 
Northern  ,, 
Eastern  ,, 
Southern  ,, 
Western  ,, 
Sub^irhan  Districts, 
Typists, 
Draughtsmcm , 
Joiner, 

Engineer  and  Caretaker  of  Chambers 


P.  B.  Mackintosh,  with  3  Assistants. 
George  Anderson,     , ,    3       , , 
James  Neil,  , ,    2  ,, 

William  M 'Keith. 
Hugh  P.  Dempster. 
D.  M'Calliim. 
Wm.  J.  Allen. 

William  M'Neil,  with  2  Assistants. 

Miss  J.  Barr  and  Miss  E.  R.  Walker. 

John  Burnside. 

John  MacAdie. 

Thos.  Boyd,  with  6  Cleaners. 


8  District  Inspectors — 

Henrj'  Watt  (Central). 
James  Paterson  (Southern). 
Robt.  N.  Crawford  (Eastern). 

S7  Nuisance  Inspectors — 

Robert  Allan  (Xorthern). 
Robert  Allan  (Southern). 
Wm.  Brymer  (Central). 
Arch.  Chalmers  (Eastern). 
John  Donaldson  (Northern). 
J.  0.  Eerguson  (South-Sub.). 
William  Eraser  (Northern). 
Joseph  Hepburn  (Western). 


OUTDOOR  STAFF. 

Christopher  Eletcher  (Western). 
John  P.  Hart  (South-Suburban). 
William  Miller  (Northern). 

John  Hillis  (Western). 
William  Latto  (Central). 
Joseph  Martin  (Eastern). 
Jas.  S.  Murray  (North-West). 
A.  M'Callum  (Western). 
Alex.  Macdoiigall  (North-West). 
William  M'Ghie  (Central). 
Charles  M'Jarrow  (Eastern). 


Jas.  L.  Dobson  (North-West). 
Hugh  Wood  (Kinning  Park), 


Peter  M'Killop  (Eastern). 
John  Purcell  (South-Suburban). 
William  Ramsay  (Northern). 
John  Robertson  (Soutli-Sub. ). 
Thos.  D.  Seton  (Northern). 
Jas.  Wedderspoon  (Southern). 
Alex.  Young  do. 


Jas.  Algie  (Northern).       John  Boyd  (Eastern).       David  Porter  (Southern).       Wm.  Roy  (Central). 
(These  four  are  Special  Drain  and  Plumber  Work  Inspectors,  with  7  Junior  Assistants.) 


8  Female  Inspectors — 

Miss  Dewar  (Central). 
Miss  Jamieson  (Southern) 
Miss  Cameron  (Western). 


Miss  Crawford  (Eastern). 
Mrs.  Stewart  do. 
Miss  Allan  (Northern). 


Miss  Seott  (Northern). 
Mrs.  Crabb  (North-West). 


6  Night  Inspectors  of  Ticketed  Souses — 

David  Gellatly.  David  Myles. 

James  Hutchison.  Andrew  Logan. 

Inspector  of  Common  Lodging-Houses  and  Boarding-Hoiises, 
Do.       Shipping  in  Harbour  ( Port  Local  Aidhority ),  .. 


James  M'Grath. 
John  Stuart. 


6  Factory  and  Workshop  Inspectors — 


R.  L.  Ashford  (Central). 
T.S.  Logie  do. 

4  Food  and  Drugs  Inspectors — 
Wm.  Denovan. 

Shop  Honrs  Inspector, 

Fish  Inspector, 

4  Inspectors  of  Smoke, 


Alex.  M'Gilvray  (Central). 
J.  Hannah  (Eastern). 


D.  Macpherson. 
Geo.  Maconnachie. 


A.  M 'Cowan  (Northern). 
J.  Patterson  (Southern). 


A.  B.  Findlay. 


M.  Kerr. 


Allan  Miller. 


  ...       ...       ...    Wm.  T.  Armstrong. 

   Geo.  B.  Harvey. 

Colin  B.  Park,  Henry  J.  Mackay,  Alex.  Gunn,  and  John  Young. 


15  Caretakers  of  Open  Spaces  and  Children's  Playgrounds. 


Indoor  Disinfecting  Staff. 
Thomas  B.  Watson  and  4  Whitewashing  Assistants. 

Outdoor  Disinfecting  Staff. 

Belvidere  Wash-Home — 

Robert  Easton  (Superintendentl.  John  Mackay  J  Engineer),  and  9  Male  and  10  Female  Employees. 
Ruchill  Wash-House — 

Ered  N.  Banks  (Superintendent),  Jas.  Clarkson  (Engineer),  and  9  Male  and  10  Female  Employees. 


INDEX. 


Sanitary  Administration — 

Local  Authority  and  Officials,        ------  ^    -       -  3 

Staff  of  Sanitary  Inspector's  Department,      ------  4 

Index,   -------  -----       -  5 

Inspector's  Report,     -----------  7 


Skeleton  Map. 
Appendix  I. — 

Table  showing  the  Area  in  Acres  ;  Persons  per  Acre  ;  Houses  Inhabited  ; 
and  the  Estimated  Population  (compared  with  last  year  and  the 
Census  of  1901):  also  Houses  Ticketed  for  Night  Inspection; 
Common  Lodging-houses,  Seamen's  Boarding-houses,  and  Farmed- 
out  Houses  on  the  Registers ;  the  Number  of  Nuisances  recorded 
per  Acre,  per  100  Houses  inhabited,  and  per  100  Workshops  in 
each  of  the  26  Wards  of  the  City  of  Glasgow,  for  1905 ;  with 
a  Skeleton  Map  attached,  showing  the  Boundaries  and  relative 
position  of  each  Ward ;  and  the  Number  of  Stables  for  Horses 


in  each  Ward  therein,     ---------  32-33 

Appendix  II. — 

Nuisances  dealt  with,     ----------  34-3-5 

Smoke  Testing  of  Drains,       ---------  34-35 

Common  Lodging-houses  and  Boarding-houses  for  Emigrants,        -        -  36-37 

Ship  Inspections  under  the  Port  Local  Authority,    -       -       -       -       -  36-37 

Houses  Let  in  Lodgings  and  Farmed-out  Houses,         .       -       .       -  36-37 

Night  Inspections  for  Overcrowding,      -------  36-37 

Visits  by  the  Lady  Inspectors,      --------  38-39 

Infectious  Diseases,  Disinfections,  ikc,    -------  38-39 

Vaccinations  (Free),        ----------  40-41 

Bakehouses  Inspected,     ---------  40-41 

Factories,  Workshops,  and  Home  Workers,    ------  40-41 

Smoke  Prevention,  -----------  42-43 

Byres,  Dairies,  and  Milk  Shops,    --------  42-43 

Unwholesome  Food,       ----------  44-45 

Food  Adulteration,        ----------  44-45 

Margarine  Act,  Contraventions,      --------  44-45 

Fish  and  Game  Inspections,   ---------  46-47 

Limewashing  of  Ashpits  (Cholera  Precautions),      -        .        -       -        .  46-47 

Pteception-Houses  (for  Quarantine),        -------  46-47 

Interments  under  the  Public  Health  Act,  1897,    -----  46-47 

Shop  Hours  Act,  Inspections,        --------  46-47 

Seats  for  Shop  Assistants  Act,  Inspections,      ------  46-47 

Appendix  III. — 

Return  of  the  Work  done.  Materials  used,  (fee,  at  tlie  Wash-house  at 

Belvidere,        -------              -       -       .  48 

Appendix  IV. — 

Return  of  the  Work  done,  Materials  used,  cfec,  at  the  Wash-house  at 

Ruchill,   ------------  48 

Appendix  V. — 

Statement  of  Time  and  Material  in  the  carrying  out  of  Repairs  done  by 

the  Staff,  49 
Appendix  VI. — 

Abstract  of  Workshops   Measured   and    Registered    during  the  year, 

including  Restaurants,      ---------  50-52 

Appendix  VII. — 

Total  Number  of  all  Workshops  and  Employees  on  the  Registers,  -  -  53-56 
Appendix  VIII. — 

Complaints  and  Notices  from  H.M.'s  Inspector  of  Factories,  -  -  -  57 
Appendix  IX. — 

Kinning  Park  Sanitary  Inspector's  Report,      ------  58-61 


THE 

SANITARY  CONDITION  OF  GLASGOW 

In  1905. 


To  THE  Honourable  the  Lord  Provost  and  Members 
OF  the  Corporation. 

My  Lord  Provost  and  Gentlemen, 

Judged  by  tlie  rougli-aud-ready  standard  of  the 
death-rate,  Glasgow  may  be  considered  a  healthier  city  in  1905  than  it  has 
ever  been  before.  In  his  summary  for  the  year.  Dr.  Chalmers  shows  that  the 
^  number  of  persons  who  died  during  1905  was  953  less  than  died  in  1904,  and 
642  less  than  died  in  1903.  The  actual  death-rate  for  1905  was  18"0,  in  place 
of  18"8  in  the  previous  year. 

On  the  other  hand,  infectious  diseases  appear  to  have  been  more  numerous. 
Eliminating  Phthisis,  Diarrhceal  Diseases,  Chickenpox,  and  Anthrax,  there  were 
3,099  more  known  cases  in  1905  than  in  1904.  This  increase  is  more  than 
accounted  for  by  the  prevalence  of  Measles,  of  which  there  were  4,197  cases 
more  than  in  the  previovis  year. 

The  greatest  diminution  occurs  in  the  cases  of  Smallpox,  only  4  being 
recorded  last  year,  against  870  in  1904.  Scarlet  Fever  and  Enteric  also  show  a 
considerable  reduction— 589  cases  in  the  former  and  177  cases  in  the  latter.  It 
is  satisfactory  to  note  that  as  many  as  1,858  cases  of  infectious  diseases  were 
discovered  and  reported  by  the  officers  of  the  epidemic  staff. 

What  are  known  as  zymotic  diseases  caused  1,998  deaths,  or  104  fewer  than 
in  1904 — a  happy  result,  when  one  takes  into  account  the  large  increase  in 
known  cases  last  year. 

Owing  to  the  successful  struggle  of  the  Health  Department  against  Small- 
pox, re-vaccinations  have  enormously  declined,  only  1,003  persons  having  been 
operated  on,  in  place  of  11,164  in  1904.  306  primary  vaccinations  were  done 
in  the  Office  and  the  Hospitals  during  the  year. 

DISINFECTION. 

11,608  apartments,  lobbies,  and  closets  were  disinfected  by  spraying  or 
fumigation  during  the  year,  and  660  over  and  above  this  were  whitewashed. 
11,487  beds  and  pillows  were  treated  at  the  two  Sanitary  Wash-houses  in  the 
steam  disinf  ectors ;  694  carpets  were  dealt  with,  and  492,812  articles  of  clothing 
were  washed ;  while  4,622  bundles  of  clothing  were  of  such  a  nature  that  they 
had  to  be  speciall}^  treated  under  steam  pressure.  The  number  of  infected 
beds  destroyed  by  fire  was  2,175. 

In  the  washing  process,  16,829  lbs.  of  soap  and  soap  powder  were  used,  or 
about  51  ounces  per  article  treated. 

During  the  year  a  high-pressure  "  Decoudun  "  ironing  machine  was  erected 
at  the  Euchill  Sanitary  Wash-house,  which  has  expedited  the  work  of  drying, 
besides  enabling  the  Department  to  send  home  many  of  the  larger  linen  and 
cotton  articles  in  a  much  more  workmanlike  condition  than  formerly.  So 
successful  has  this  addition  been,  that  I  propose  this  year  preparing  plans  for  a 
similar  addition  to  the  plant  at  Belvidere  Wash-house. 


NUISANCES. 

414,722  separate  inspectious  for  tlie  discovery  of  uuisauces  were  made  by 
the  male  staff  and  57,981  by  the  female  staff  during  1905,  resulting  in  the 
discovery  of  44,979  nuisances  by  the  former  and  1,625  by  the  latter. 

The  female  staff,  in-  addition,  visited  on  1,848  occasions  the  Board  schools 
in  quest  of  dirty  and  verminous  children,  under  Section  15  of  the  Glasgow  Cor- 
poration (Police)  Order,  1904.  4,221  children  were  submitted  by  the  School 
Board  officials  for  inspection,  and,  out  of  these,  2,636  were  found  to  be  in  a 
dirty  or  verminous  state.  The  homes  of  the  affected  children  were  carefully 
inspected — 165  of  which  were  found  in  an  unclean  state,  and  in  161  cases  the 
bedding  was  found  in  a  filthy  condition.  Only  in  five  cases  was  it  found  needful 
to  put  into  operation  the  full  powers  of  the  Act,  and  take  the  children  from 
their  parents  in  order  to  have  them  cleansed  by  the  officials  of  the  Corporation. 
In  these  cases  this  Avas  done  in  the  Reception-houses  by  the  Matrons  and  their 
staff.  With  two  exceptions,  the  cleansing  of  the  filthy  bedding  and  houses 
was  done  in  every  case  by  the  occupiers  on  receipt  of  the  statutory  notice. 

The  Act  is  a  summary  one,  and  it  is  working  excellently  in  the  public 
interest,  but,  notwithstanding  this,  Avhen  a  recalcitrant  person  is  met  with,  a 
large  amount  of  valuable  time  is  spent  before  he  can  be  compelled  to  conform 
to  the  law.    An  illustration  will  best  exhibit  this. 

On  the  21st  of  March,  1905,  three  children  of  a  man,  A.  G.,  were  brought 
before  the  attention  of  one  of  the  female  inspectors  in  a  school  on  the  south  side 
of  the  river.  Two  of  them  were  found  verminous  and  dirty,  and  the  third  one 
dirty  only.  Notice  was  sent,  and  for  a  time  some  improvement  was  made.  On 
re-examination,  however,  on  the  18th  of  April,  all  three  were  again  found  in 
the  same  filthy  state.  Proceedings  were  taken,  under  Section  9  (2)  of  the  Order, 
against  the  father  on  the  21st  of  April,  when  he  was  convicted  in  the  Police 
Court,  and  ordered  to  cleanse  the  bed  and  body  clothing  in  the  house  fortliAvith. 
On  25th  April  I  sent  two  of  the  female  inspectors  to  ascertain  what  progress  had 
been  made,  but  admission  to  the  house  was  refused.  An  application,  accordingly, 
Avas  made  to  the  Magistrate  next  day  for  a  warrant  for  forcible  entry.  Armed 
with  this,  the  two  inspectors  on  the  following  day  gained  access  to  the  house, 
and  found  that  the  clothing  of  the  children  had  been  cleansed. 

On  the  2nd  of  May  the  school  was  again  visited,  and  the  same  three  children 
were  found  as  bad  as  before.  Arrangements  were  there  and  then  made  for 
their  removal  from  the  school  to  the  Reception-house  in  South  York  Street  on 
the  3rd  of  May  at  11  a.m.,  Avhere  they  Avere  thoroughly  cleansed,  and  detained 
until  their  clothing  had  been  treated  at  the  Sanitary  Wash-house.  They  were 
then  sent  back  to  their  parents  at  8.20  p.m. 

Fully  twenty-eight  hours  were  spent  in  this  duty  by  each  of  the  inspectors 
engaged,  apart  from  the  time  and  trouble  taken  with  the  children  at  the 
Reception-house  and  with  their  clothing  at  the  wash-house.  Even  yet  neither 
the  house  nor  the  chilHren  are  in  a  cleanly  condition,  as  I  found  on  a  personal 
visit  recently.  The  family  are  of  the  alien  tribe — one  of  Avhose  chief  character- 
istics appears  to  be,  like  that  of  the  saints  and  hermits  of  early  Christian  times, 
a  desire  to  live  amid  filth  and  disorder. 

In  September,  additional  Avork  in  connection  Avith  the  visitation  of  ncAvly- 
born  infants  Avas  put  upon  the  female  inspectors,  particularly  in  homes  Avhere 
the  services  of  the  maternity  nurses  were  required.  Doubtless  much  good  and 
useful  Avork  has  been  and  is  done  by  them  in  this  direction,  but,  as  this  class  of 
Avork  groATs,  it  unavoidably  retards  the  progress  of  their  operations  in  the 
domain  of  house-to-house  visitation  and  inspection.  I  find,  from  a  recent 
return  of  their  inspections  of  the  loAver-class  dAvellings,  that,  AA^hereas  from 
January  and  February,  1904,  they  had  inspected  16,240  houses,  only  7,670 
visits  had  been  paid  to  similar  houses  during  the  same  months  in  1906. 

The  regular  inspection  of  children  in  the  schools,  and  the  consequent 
visitation  in  the  homes  of  those  found  in  a  filthy  or  verminous  state,  have  con- 
tributed to  this  great  reduction  in  their  regular  house-to-hoiise  visitations ; 
still,  the  continual  visitation,  for  statistical  and  advisory  purposes,  of  houses 


9 


in  whicli  infants  are  born,  has  largely  caused  the  reduction  specified.  As  time 
jDroceeds,  I  fear,  on  this  account,  it  will  be  advisable  to  consider  the  expediency 
of  appointing  a  special  stafi  of  trained  visitors  for  infant-mortality  work  alone. 

With  regard  to  the  ordinary  nuisance-inspection  work,  the  following  seven 
Sanitary  Districts  head  the  list  as  nuisance  producers,  viz.:  — 

Ward     XVI.  (Cowcaddens),  ...    3,307  nuisances,  or  19-11  per  acre. 
XIV".  (Sandyford),     ...    2,141         ,.       or  15-52 
IX.  (Blackfriars),     ...     2,022         „        or  14-00 
„     XVIII.  (Hutchesontown),     2,866        „       or  12-80 
XIX.  (Gorbals),         ...    2,231         „       or  9-19 
XII.  (Broomielaw),    ..:       950  or  9-13 

II.  (Calton),  ...    2,578        ..       or  8-00 

The  average  for  the  City  was  3'35  nuisances  per  acre  for  the  year,  or 
slightly  under  the  figure  for  1904,  which  was  3"50. 

The  relative  position  of  the  other  wards  in  the  City  in  this  respect  and 
other  information  of  interest  therein  will  be  found  detailed  in  Appendix  I. 

It  may  be  noted  here  that  the  ordinary  nuisance  statf  were  specially 
engaged,  for  the  purposes  of  the  Provisional  Order  of  1905,  in  an  organised 
inspection  of  the  2,573  stables  within  the  City  boundaries,  which  will  be 
referred  to  in  detail  under  a  special  heading.  The  number  of  these  found  in 
each  ward  is  given  in  Appendix  I. 


MOYEME^^T  OF  POPULATION. 

A  few  words  may  be  added  here  as  a  probable  explanation  of  the  figures 
showing  the  increase  or  decrease  of  houses  and  population  in  some  of  the  wards 
since  last  year  and  since  the  Census  year,  1901. 

Ward  I.  (DalmarnocTi). — ISTo  tenements  in  this  ward  have  been  removed, 
but,  since  the  erection  of  the  new  Corporation  Gras-works  at  Provanmill,  large 
numbers  of  the  workers  have  left  to  take  up  house  nearer  the  new  works ;  others 
have  removed  to  "Ward  III.  (Mile-end),  to  be  nearer  the  Parkhead  Porge ;  and 
in  other  cases  it  has  been  ascertained  that  a  number  of  families  in  this  ward 
have  emigrated  to  Canada.  Consequently  several  streets  here  have,  from  being 
well  populated,  become  greatly  denuded  of  their  population,  and  there  are  many 
empty  houses. 

Ward  III.  (MUe-end ). — A  large  number  of  new  tenements  have  in  recent 
years  been  erected  in  this  ward  round  about  Parkhead  Cross  and  the  Forge, 
which,  as  indicated  above,  have  attracted  a  considerable  number  of  families 
from  adjacent  wards. 

Ward  IV.  (Whitevale). — A  number  of  low-class  tenements  have  been  con- 
demned in  this  ward,  and  taken  down.  There  are  also  many  houses  remaining 
presently  unlet,  the  people  having  migrated  to  newer  dwellings  in  other  wards. 

Ward  V.  (^Detmisfonn). — Much  new  building  has  in  recent  years  been  done 
in  this  ward,  particularly  about  Alexandra  Park  and  its  immediate  neighbour- 
hood, which  accounts  for  the  increase  shown  in  the  table. 

Ward  VI.  ( S prinqhurn ) . — Around  Petershill  Poad  and  Springbum  Road, 
and  in  Bedlay  Street,  a  large  number  of  new  tenements  have  been  erected,  the 
increase  of  population  consequently  being  almost  as  great  as  that  in  Ward  Y. 

Ward  VII.  (Cowlnirs). — The  same  remark  applies  to  this  ward,  in  which, 
on  the  north  and  south  sides  of  Keppochhill  Eoad  and  vicinity,  much  building 
of  new  tenements  has  been  proceeding. 

Ward  VIII.  (Toicnhead ). — It  is  not  possible  to  explain  the  specific  reasons 
which  have  led  to  a  reduction  of  1,63G  persons  in  this  ward  since  1901.  Many 
houses  are  reported  to  be  empty  and  "  to  let."  Probably  it  is  due  to  families 
flitting  to  newer  tenements  in  the  adjacent  ward  of  Springburn.  A  few  tene- 
ments in  Garnkirk  Street  and  Coatbridge  Street  have  been  removed,  but  these 
were  not  sufficient  in  number  to  account  for  the  rediiction  specified. 


10 


Ward  IX.  (Blach friars). — The  diminution  in  population  of  this  ward  is 
serious — 1,956  since  last  year,  making  a  total  of  9,284  since  the  Census  year 
(1901).  It  is  in  a  great  measure  due  to  the  destruction  of  many  old  tenements. 
Eight  or  nine  tenements  lying  on  the  Avest  side  of  High  Street,  and  extending 
north  to  Bottenrow,  have  been  removed  by  the  Improvement  Trust,  and  re- 
placed by  buildings  of  modern  construction.  In  Stockwell  Street  also,  from 
Bridgegate  to  Goosedubbs  and  Aird's  Lane,  four  tenements  have  been  taken 
down,  and  reconstruction  is  proceeding.  The  old  tenements  in  Bridgegate, 
from  St.  Margaret's  Place  eastwards  to  Saltmarket  Street  and  southward  to 
Jail  Sqiiare,  have  been  demolished,  and  new  buildings  are  being  erected.  In 
this  ward  on  the  south  side  of  the  river,  the  demolition  of  insanitary  back  lands 
behind  Rose  Street  and  Crown  Street  has  occurred,  whereby  much-needed  light 
and  air  have  been  let  in  to  what  were  previously  dismal  and  evil-smelling  courts, 
where  nuisance  of  every  description  was  constantly  present.  These,  of  course, 
cannot  be  reconstructed. 

Ward  XI.  (Blythswood). — In  this  ward,  house  demolition  has  been  going 
on  in  Renfield  Street,  from  Renfrew  Lane  up  to  Renfrew  Street,  in  order  to 
make  room  for  the  new  "  Pavilion  Theatre  of  Varieties."  A  large  tenement  at 
the  corner  of  Sauchieh'all  »Street  and  Cambridge  Street,  and  also  one 
at  90  Sauchiehall  Street,  have  been  removed  and  replaced  by  warehouse 
premises. 

Ward  XII.  (Broomielaw). — Representations  and  demolitions  under  the 
Housing  of  the  Working  Classes  Act,  1890,  have  mainly  been  the  cause  of  the 
reduction  of  the  population  here.  It  was  miich  needed.  The  sanitary  district 
formerly  known  as  "  Brownfield  "  was  for  long  the  sorest  spot  in  Glasgow.  It 
is  now  getting  comparatively  respectable.  At  29  Brown  Street,  67  Brown 
Street,  9  Carrick  Street,  20  Carrick  Street,  29  West  College  Street,  14  M'Alpine 
Street,  and  53  M'Alpine  Street,  many  back-land  dwellings  have  now  disappeared, 
and  can  never  be  replaced.  The  tenements  at  the  corner  of  West  Campbell 
Street  and  Cadogan  Street,  and  also  at  the  corner  of  Argyle  Street  and  Pitt 
Street,  have  been  entirely  removed  and  reconstructed.  Other  undesirable 
buildings  still  remain,  but  in  time  means  may  be  found  to  accomplish  their 
demolition  also.  In  no  district  has  more  satisfactory  work  been  accomplished 
in  recent  years. 

Ward  XVI.  (Coivcaddens). — The  marked  decrease  here  is  accounted  for 
by  the  closure  and  destruction  of  insanitary  property  in  M'Adam  Lane,  Mait- 
land  Street,  Maitland  Lane,  Muse  Lane,  Stirling  Street,  Water  Street,  Milton 
Street,  Debbie's  Loan,  Renfrew  Street,  and  Ann  Street,  while  many  damp 
underground  dwellings  in  Grove  Street,  Abercom  iStreet,  and  vicinity  have  been 
closed  under  the  Public  Health  Act.  Further  work  of  this  nature  still  remains 
to  be  accomplished  before  this  Avard  can  be  said  to  be  in  a  reasonably  healthy 
state. 

Ward  XVIII.  (Ilutchesontown).  —  A  large  increase  of  population  has 
occurred  here  since  1901.  It  is  one  of  the  expanding  wards  of  the  City,  much 
building  of  new  tenements  having  been  done  during  the  past  four  years.  The 
temporary  set-back  since  1904  is  probably  due  to  migration  to  other  districts 
or  to  parts  outwith  the  City. 

Ward  XIX.  ( Gorhals). — New  tenements  have  recently  been  erected  in  this 
ward  in  Cuthbertson  Street,  Langside  Road,  Yictoria  Road,  Coplaw  Street,  and 
Cromwell  Road,  Avhich  accounts  for  the  increase  of  houses  and  population 
recorded. 

There  is  little  worthy  of  special  note  in  the  remaining  wards.  Govanhill, 
Langside,  Pollokshields,  Kelvinside,  and  Maryhill — lying,  as  they  do,  on  the 
fringes  of  the  City — all  naturally  shoAv  a  great  expansion,  due  to  the  overfloAv  of 
the  population  to  the  suburbs.  The  Avhole  movement  exhibits  a  displacement 
of  population  to  the  extent  of  some  40,000  persons.  This  is  the  general  tendency 
at  the  present  time,  and,  doubtless,  is  a  natural  one,  facilitated  by  cheap  transit 
by  tram-car  and  a  vast  amount  of  house  building  on  the  outskirts. 


UNINHABITABLE  AND  TICKETED  HOUSES. 

As  a  very  full  report  was  issued  in  the  first  niontli  of  this  year  showing  the 
operations  of  the  "  Back  Lands  Committee,"  it  is  unnecessary  here  to  dwell  upon 
the  good  work  which  has  been  done  during  1905  with  regard>  to  uninhabitable 
dwellings.  The  operations  were  carried  out  under  the  Housing  of  the  Working 
Classes  Act,  1890,  Part  II.,  and,  to  allow  of  the  free  play  of  this  Act,  no  work 
has  been  carried  out  under  Section  32  of  the  Local  Police  Act,  which  gives 
power  to  close,  but  not  to  demolish,  uninhabitable  dwellings. 

Regarding  ticketed  houses,  our  operations  have  been  extended  by  the 
additional  powers  of  ticketing  given  by  the  Provisional  Order  of  1904.  The 
following  statement  in  tabular  form  exhibits  the  state  of  matters  at  the  present 
time  :  — 


Ward. 

Total 
No. 

Giving 

Accommodation  (at  400  cuhic  feet  per  Adult)  for 

2 

Adults. 

21 
Adults. 

3 

Adults. 

Si 
Adults 

4 

Adults 

4i 

Adults 

5 

Adults 

Adults 

6 

A  emits 

61 
Adults. 

1 

1,389 

19 

no 

189 

214 

235 

244 

92 

128 

110 

8 

40 

2 

1,601 

29 

201 

290 

238 

203 

150 

147 

277 

18 

16 

32 

3 

2,203 

20 

151 

372 

384 

304 

266 

332 

334 

17 

6 

17 

4 

953 

13 

71 

145 

203 

154 

76 

51 

142 

13 

39 

46 

5 

201 

5 

31 

55 

27 

25 

19 

20 

16 

3 

6 

1,409 

12 

45 

140 

287 

259 

271 

160 

216 

9 

5 

5 

7 

409 

■-> 

21 

33 

75 

83 

46 

59 

69 

11 

6 

4 

8 

1,333 

21 

118 

210 

186 

112 

103 

124 

279 

78 

71 

31 

9 

756 

16 

69 

78 

106 

70 

158 

153 

82 

17 

6 

1 

10 

8 

6 

2 

1 1 

I 

4 

12 

484 

8 

24 

48 

30 

62 

57 

86 

76 

26 

27 

40 

13 

1,650 

17 

121 

217 

216 

222 

130 

154 

259 

166 

87 

61 

14 

817 

25 

95 

162 

168 

83 

57 

85 

80 

37 

19 

6 

15 

16 

2,843 

29 

227 

413 

452 

361 

263 

342 

396 

176 

105 

79 

17 

723 

4 

30 

75 

206 

105 

70 

79 

49 

33 

36 

36 

18 

969 

2 

61 

170 

184 

148 

120 

118 

142 

12 

10 

2 

19 

997 

19 

131 

190 

188 

108 

102 

117 

112 

8 

15 

7 

20 

939 

14 

72 

196 

207 

91 

72 

105 

136 

28 

18 

21 
22 

227 

1 

5 

20 

59 

36 

16 

87 

1 

2 

23 

24 

25 

302 

1 

9 

25 

48 

37 

57 

78 

46 

1 

26 

329 

3 

20 

67 

76 

52 

34 

16 

31 

16 

14 

Total, 

20,547 

257 

1,596 

3,028 

3,506 

2,797 

2,349 

2,358 

2,948 

794 

491 

423 

12 


The  work  accomplislied  by  the  night  statf  is  shown  in  the  following  abstract 
Table,  which  has  been  prepared  from  their  weekly  returns.  For  convenience, 
the  figures  are  given  as  applicable  to  the  seven  Police  Divisions  of  the  City:  — 


a 
_o 

Houses 
Overcrowded. 

Prosecutions. 

■tment 
ted. 

ftment 
ted. 

*-3 

o 

^  2 

Police 
Division. 

No.  of  Inspe^ 

No. 

Percentage  on 
Inspections. 

No. 

Percentage  on 
Cases  found. 

Number 
of  Convictions. 

No.  Fined. 

Amount 

of 
Fines. 

No.  of  One-Aj 
Houses  Insj: 

No.  of  Two- A] 
Houses  Insj 

1 

2 

3 

4 

5 

6 

7 

8 

£    s.  d. 

9 

10 

Centi'al,  - 

1,547 

95 

6-14 

40 

42-10 

29 

10 

1  12  6 

1,085 

462 

Northern, 

7,426 

643 

8'65 

334 

51-94 

261 

153 

28  13  0 

4,200 

3,157 

"Western,  - 

6,560 

509 

7-75 

236 

53-75 

201 

108 

23    0  6 

3,255 

.2,629 

Southei'n,  - 

8,614 

636 

7-38 

277 

43-55 

205 

94 

22    6  0 

5,573 

3,010 

Eastern,  - 

14,229 

1,029 

7-08 

426 

41-39 

277 

113 

21    9  0 

10,329 

3,900 

Maryhill,  - 

614 

31 

5-04 

16 

51-61 

12 

6 

1    2  6 

537 

75 

St.  RoUox, 

7,485 

404 

6-01 

192 

47-52 

132 

41 

9  18  6 

4,641 

2,003 

Total,  - 

46,475 

3,347 

7-20 

1,521 

46-41 

1,117 

525 

108    2  0 

29,620 

15,236 

Cases  of 
Overcrowding  in  One 
Apartments. 

Cases  of 
Overcrowding  in  Two 
Apartments. 

Nature 
of  Overcrowding. 

Extent 
of  Overcrowding. 

CP 

Average 
Monthly  Rents. 

No. 

Percentage. 

No. 

Percentage. 

Wholly 
by  Lodgers. 

By  Families 
only. 

No. 

with  ^-Excess. 

No. 

with  1  Excess. 

No.  with 
over  1  Excess. 

No.  of  Hous 
Empty. 

One 
Apartments. 

Two 
Apartments. 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

65 

5-99 

29 

6-27 

38 

44 

12 

33 

50 

18 

9/4 

10/11 

381 

9-07 

256 

8-10 

235 

322 

66 

255 

322 

192 

9/1 

12/ 

266 

8-17 

167 

6-35 

154 

222 

55 

177 

277 

70 

10/2 

11/2 

430 

7-71 

198 

6-57 

239 

309 

15 

280 

341 

122 

11/11 

15/10 

747 

7-23 

272 

6-98 

353 

552 

18 

463 

548 

462 

8/5 

9/10 

23 

4-28 

8 

10-66 

17 

14 

3 

11 

17 

12 

8/1 

14/2 

309 

6-65 

85 

4-24 

99 

238 

12 

159 

233 

138 

8/11 

9/5 

2,221 

7-49 

1,015 

6-66 

1,135 

1,701 

181 

1,378 

1,788 

1,014 

9/5 

11/11. 

13 


That  the  miisance  of  overcrowding  is  gradually  being  abated  is  shown  by 
the  fourth  column  (the  percentage  last  year  being  8'48),  while  under  the 
sixteenth  and  seventeenth  headings  the  nature  of  the  overcrowding  is  exhibited ; 
the  next  three  columns  give  its  extent ;  and  the  last  two  show  the  average 
monthly  rent  charged  for  a  one  and  a  two-roomed  ticketed  house.  It  will  be 
noted  that  the  rents  charged  for  single-apartment  houses  in  the  Southern  and 
Western  Divisions  are  considerably  in  excess  of  those  in  the  other  districts. 

The  unoccupied  ticketed  houses  number  1,014,  which  is  almost  5  per  cent, 
of  the  total,  20,547. 

FARMED-OUT  HOUSES. 

The  following  Table  gives  the  figures  for  farmed-out  houses  in  Glasgow 
during  1905 :  — 

There  is  nothing  of  a  special  nature  to  report  regarding  them.  Some  of 
them  (in  about  a  dozen  properties)  are  houses  of  a  suspicious  character  morally, 
and  strict  supervision  is  constantly  required  in  these,  in  order  to  keep  down 
nuisance. 


Farmed-out  Houses  in  the  City  as  at  30th  December,  1905. 


One 

Apartment. 

Two  Apartments. 

Total  Inmates. 

Ward. 

Total 
No. 

of 

HoilSGS. 

Total  No. 

Inmates. 

Total  No. 

d 

'A 

Inmates. 

Clj 

No.  Occu 

No.  Em] 

Adults. 

Children. 

o 
o 
O 

6 

Adults. 

Children. 

Adult 

Childri 

2 

293 

172 

155 

17 

327 

80 

121 

110 

11 

344 

135 

671 

215 

3 

25 

25 

21 

4 

43 

10 

43 

10 

4 

67 

27 

25 

46 

8 

40 

36 

4 

115 

38 

161 

46 

5 

33 

16 

16 

34 

7 

17 

17 

67 

6 

101 

13 

6 

16 

13 

12 

1 

24 

8 

3 

3 

6 

3 

30 

11 

8 

83 

75 

71 

4 

147 

32 

8 

6 

2 

23 

5 

170 

37 

9 

148 

54 

53 

1 

112 

37 

94 

94 

321 

74 

433 

111 

10 

16 

1 

1 

2 

1 

15 

15 

54 

6 

56 

7 

12 

85 

23 

22 

1 

44 

18 

62 

62 

203 

96 

247 

114 

13 

112 

75 

69 

6 

130 

45 

37 

34 

3 

93 

42 

223 

87 

14 

65 

65 

38 

27 

82 

26 

82 

26 

16 

11 

11 

10 

1 

20 

3 

20 

3 

18 

49 

31 

30 

1 

56 

25 

18 

16 

2 

46 

11 

102 

36 

19 

48 

23 

20 

3 

45 

10 

25 

21 

4 

74 

12 

119 

22 

20 

63 

38 

38 

142 

34 

25 

23 

2 

30 

14 

■172 

48 

Total, 

1,114 

649 

581 

68 

L254 

344 

465 

437 

28 

1,376 

442 

2,630- 

786 

Note — 27  of  the  2-apartment  houses  in  Ward   2  have  only  1  room  occupied. 
6  do.  do.  do.  9  do.  do. 

10  do.  do.  do.         12  do.  do. 


COMMON  LODGING-HOUSES  AND  SEAMEN'S  BOAEDING-HOUSES. 

There  were  at  the  end  of  1905,  63  Common  Lodging-liouses  on  the  Eegister, 
with  9,768  beds,  as  against  56,  with  9,346  beds,  at  the  end  of  1904.  The 
Seamen's  Boarding-houses  number  35,  with  623  beds.  No  prosecutions  were 
instituted  against  keepers  during  the  year. 

The  following  Table  will  show  the  present  position  at  a  glance :  — 


Class  of  House. 

Ward. 

Inspections. 

Complaints 
Notified. 

Complaints 
Removed. 

Houses 
Measured 

and 
Registered. 

Houses 
Removed 

from 
Register. 

2 

1,288 

71 

68 

A 

3 

19 

1 

I 

1 

1 

4 

316 

14 

14 

5 

43 

I 

Common 
Lodging- 

8 
9 

1  9 
i  / 

47 
1,013 

Jit 

2 
51 
i  o 

2 
48 
I* 

5 

1 
I 

1 

3 

i 

HOUSES, 

13 

88 

15 

16 

1 

16 

282 

10 

9 

J.  V 

ovo 

i  o 

20 

79 

2 

2 

25 

44 

1 

1 

Total, 

4,041 

194 

190 

12 

5 

Seamen's 

AND 

Emigrants'  < 
Boarding-  1 

12 
13 
18 

1,837 
61 
2 

27 

25 

5 
1 

8 

HOUSES, 

I 

20 

572 

8 

8 

1 

2 

Total, 

2.472 

35 

33 

7 

10 

Note. — 7  Lodging-houses  and  4  Boarding-houses  were  transferred  during  the  year  to  other  keepers. 


During  the  year  further  improvements  of  a  structural  nature  have  been 
carried  oiit  in  manj^  of  the  houses,  and  in  five  of  them  we  got  the  existing  beds 
removed  and  replaced,  and  the  bedding  replenished. 

A  special  detailed  report  has  now  been  made  on  each  common  lodging- 
house  in  the  City,  in  view  of  re-registration  in  May,  1906.  These  reports 
deal,  inter  alia,  with  the  important  subject  of  suitable  exits  in  case  of  fire. 
The  deplorable  disaster  which  occtirred  in  the  lodging-house  at  39  "Watson 
Street,  by  which  39  sleepers  were  suffocated  or  burned  to  death,  brought  up 
sharply  the  question  of  the  powers  given  in  the  Public  Health  Act  to  deal  with 
such  structural  matters  as  doiible  stairs  for  each  donnitory,  provision  of 
hydrants  and  hose  attachments,  composition  of  bunk  beds,  regular  patrols 
during  the  night,  &c.,  all  of  which  will  doubtless  engage  the  serious  attention 
of  the  Local  Authority  when  the  special  committee  appointed  to  enquire  into 
the  causes  of  the  disaster  have  formulated  and  issued  their  report.  Meantime, 


15 


my  report  is  before  tJie  Committee  ou  Health  for  their  consideration.  Nineteen 
lodging-houses  have  been  foimd  with  sanitary  defects  of  one  kind  or  another, 
and  20  are  specially  reported  on  to  the  Committee  as  to  the  present  state  of 
exits  for  the  sleepers  in  case  of  fire  breaking  out  during  the  night. 

With  regard  to  Seamen's  and  Emigrants'  Boarding-houses,  there  has  been 
a  decrease  since  last  year.  There  are  35  of  such  houses  on  the  Register  at  the 
present  time,  with  bed  accommodation  for  623  persons.  Four  of  them  are 
exclusively  used  by  foreign  emigrants.  In  the  others  both  classes  may  be 
housed  promiscuously. 

2,472  inspections  were  made  during  the  year  in  these  lodging-houses,  and 
35  complaints  were  notified  to  the  keepers,  but  in  no  case  was  it  necessary  to 
resort  to  prosecution  in  the  Police  Courts.  Improvements  of  a  structural  nature 
were  carried  out,  at  the  instance  of  the.  Department,  in  several  cases,  consisting 
chiefly  of  the  abolition  of  filthy  trough  privies,  the  refitting  of  wash-down 
water-closets,  and  the  provision  of  sufficient  iiriual  accommodation. 

The  number  of  foreign  emigrants  who  passed  through  the  City  during  the 
year  was  8,335 — an  increase  of  3,936  over  the  number  in  1904,  and  considerably 
more  than  has  passed  during  any  year  since  1S94.  The  following  Statement 
shows  the  number  and  nationality  of  these  emigrants.  It  will  be  observed  that 
those  of  Jewish  extraction  are  much  in  excess  of  the  others  :  — 

"  Donaldson  "  Line. 
Norwegians,     ...        ...        ...        ...        ...        ...        ...  10 

"Allan"  Line. 


Scandinavians  (Norwegians,  Swedes,  and  Danes), 
Continentals    (Russians,     Austrians,  Hungarians, 

Poles,  itc,  principally  Jews), 
Finlanders, 
Icelanders, 


Russians,  Poles,  and  Jews, 
Finlanders, 

Scandinavians, ... 

Russians, 


"Anchor"  Line. 
(  Antwerp, 
I  Rotterdam, 

Hango,  ... 
(  Sweden, 
■j  Esbjerg, 
(  Norway, 

Hamburg, 


271 

774 
297 
155 


2,209 
2,316 
851 
321 
461 
599 
71 


1,-197 


6,828 


Total,  8,335 


Probably  the  late  war,  and  the  consequent  upheaval  in  Russia,  accounts 
to  a  great  extent  for  the  increase  this  year,  but  we  may  look  forward  in  the 
future  to  a  continuous  stream  of  these  aliens  coming  temporarily,  if  not  per- 
manently, among  us,  and  it  behoves  us  to  carefully  consider  as  to  some  suitable 
means  of  so  housing  them  that  they  may  be  kept  more  easily  and  more  strictly 
under  the  watchful  care  of  the  Health  and  Sanitary  Authorities.  Meantime, 
they  are  too  apt  to  be  scattered  among  our  population,  and,  to  some  extent,  lost 
sight  of. 

The  Aliens  Act  was  intended  to  prevent  the  "  dumping  "  of  undesirables 
into  this  country,  but  it  appears,  if  they  come  in  in  numbers  not  exceeding 
twenty,  they  are  allowed  to  pass  the  Immigration  Officer  without  enquiry  either 
as  to  their  circumstances  or  as  to  their  health,  and  so  the  Act  may  be  evaded. 
Glasgow  and  the  districts  surrounding  it  have  had  a  goodly  number  of  this  class 
added  to  their  population  in  recent  years.  America  is  very  strict  as  to  the 
examination  of  such  persons,  and  if  any  sign  of  disease  of  an  infectious  or  con- 
tagious nature  is  detected  upon  them,  thej^  are  at  once  returned  here  at  the 
expense  of  the  Shipping  Companies.  Consequently,  we  have  begun  here  to  be 
much  more  careful  than  hitherto  in  our  examination  of  intending  emigrants, 
and  the  Medical  Officers  of  the  Board  of  Trade  and  the  Shipping  Companies  are 
most  assiduous  in  the  performance  of  their  duty  in  this  respect. 


16 


It  will  be  noted  that  tlie  Donaldson  Line  have  now  become  caterers  for  this 
class  of  trade  for  the  first  time,  and  have  fitted  up  one  of  their  steamers  to  carry 
passengers. 

PORT  LOCAL  AUTHORITY. 

Two  Boarding  Medical  Ofiicers  and  two  Nuisance  Inspectors  at  Greenock, 
and  one  Nuisance  and  one  Epidemic  Inspector,  with  an  Assistant,  in  Glasgow, 
constitute,  as  previously,  the  daily  working  stafi  connected  with  the  port  and 
shipping. 

The  area  in  the  City  comprises  Glasgow  Harbour,  the  Docks  in  Govan, 
Shieldhall,  Torkhill,  Partick,  and  Bowling.  When  the  docks  in  course  of 
erection  on  the  lower  reaches  of  the  river  are  completed,  the  area  of  inspection 
will  be  correspondingly  extended. 

1,870  inspections  and  287  re-inspections  of  steamers  were  made,  while  95 
inspections  and  75  re-inspections  were  made  in  sailing  vessels.  268  written 
intimations  and  10  final  notices  tinder  the  Public  Health  Act  were  served  on 
masters  as  to  nuisances  discovered,  and  238  verbal  warnings  were  given  to 
masters  as  to  the  defective  state  of  their  vessels. 

The  outstanding  feature  of  the  year  has  been  the  large  number  of  French 
sailing  vessels  which  came  to  this  port  with  cargoes  of  nickel  ore  from  the 
penal  settlement  of  New  Caledonia.  This  trade  seems  to  be  practically 
monopolised  by  French  "  wind-jammers,"  as  these  ships  are  called,  as  not  a 
British  vessel  came  to  the  Clyde  from  this  French  colony  during  the  year. 
The  inspector  reported  that  these  ships  are  well  appointed,  the  crews'  quarters 
being  "  roomy  and  comfortable,  and  in  marked  contrast  to  the  forecastles  of 
similar  British-owned  ships." 

Hndernoted  will  be  found  details  of  the  inspections,  re-inspections,  &c., 
undertaken  by  my  Inspector  detailed  for  duty  within  the  Glasgow  area,  as  also 


a  record  of  the  various  nuisances  discovered :  — 
Inspections — 

Steamers,      ...        ...        ...        ...        ...        ...  1,870 

Sailing  vessels,        ...        ...     ....        ...        ...  95 

  1,965 

Re-inspections  — 

Steamers,      287 

Sailing  vessels,        ...        ...        ...        ...        ...  75 

  362 

Warnings  given,  ...        ...        ...        ...        ...        ...  ...  238 

Intimations  issued,         ...        ...        ...        ...        ...  ...  268 

Final  Notices  served,      ...        ...        ...        ...        ...  ...  10 

Nuisances  Discovered. 

Filth- 
Floors,  wood  work,  i&c,  of  cabins,  officers'  i-ooms,  forecastles, 

and  stewards' and  cattlemen's  quarters  dirty,  ...  237 

Old  beds  within  forecastles  destroyed,      ...        ...  ...  172 

Accumulations  of  gear  and  rubbish  within  forecastles,   ...  23 

Forecastle  infested  with  vermin,   ...        ...        ...  ...  1 

Live  fowl  kept  in  crews'  quarters,  ...        ...        ...  ...  1 

Cooking  galleys  dirty,        ...        ...        ...        ...  ...  7 

Bath  rooms  or  wash-houses  dirty,  ...        ...        ...  ...  15 

Fresh  water  tanks  or  barrels  to  be  cleansed,       ...  ...  15 

Bilges  in  need  of  draining,  ...        ■  • . '  .    •  •  •        ...  •  •  •  6 

Scuppers  choked,     ...        ...        ...        ...        ...  ...  7 

"Walls  and  ceilings  of  water-closets  dirty,  . ..        ...  ...  75 

"Water-closet  troughs  fouled  or  cori'oded,  ...        ...  ...  62 

Accumulation  of  gear  within  closets,        ...        ...  ...  3 


Total,    624 


(Number  remedied,  506.) 


17 


Structural  defects — 

Officers'  rooms  defective  in  ventilation,     ...        ...        ...  7 

Forecastles  defective  in  ventilation,  or  ventilators  plugged,  91  '  ' 

Forecastles  inadequately  lighted,  ...        ...        ...        ...  5 

Forecastles  damp,    ...        ...        ...        ...        ...        ...  4 

Bunks  in  forecastle  defective  in  construction,     ...        ...  1 

Bogies  or  funnels  defective,  and  new  stoves  or  pipes  required,  61 

Ports,  port  glasses,  (fee,  leaking,  broken,  or  otherwise  defective,  109 
Hatches,  bulkheads,  skylights,  hawse  pipes,  casings,  tfec,  defective,  9 

Overhead  decks  leaking,     ...        ...        ..         ...        ...  .32 

Steam  pipes  defective,        ...        ...        ...        ...        ...  2 

Forecastle  doors,  tables,  ifec,  dilapidated,  ...        ...        ...  5 

Forecastle  without  scuppers,         ...        ...        ...        ...  1 

Better  accommodation  for  food  stuffs  required,    ...        ...  38 

Water-closets  without  locks  or  keys  (to  prevent  a  nuisance),  121 
No  water-closet  accommodation,  or  additional  water-closets 

required,          ...        ...        ...        ...        ...        ...  7 

Wood  work  of  closets  worn  out  or  broken,          ...        ...  9 

New  pans,  flush  tanks,  or  service  pipes,  (fee,  required,     ...  6 

Water-closets  deficient  in  light,     ...        ...        ...        ...  2 

Water-closets  defective  in  ventilation,      ...        ...        ...  5 

Ventilators  of  water-closets  plugged,        ...        ...        ...  2 

Lamp  room  exposed  to  men's  quarters,     ...        ...        ...  1 


Total,   518 


(Number,  remedied,  407.) 

The  "  filth  '"  nuisances  numbered  624,  and  structural  defects  were 
discovered  in  518  cases.  Of  the  filth  nuisances,  172  consisted  of  old  beds,  which 
were  either  burned  or  taken  ashore  for  removal  by  the  Cleansing  Department. 

An  improvement  of  much  value  has  been  eiSected  in  the  majority  of  ships 
carrying  native  crews,  by  the  removal  from  the  forecastles  or  sleeping  places  of 
perishable  food  stuffs  and  drinking-water  tanks  to  suitable  positions  on  the 
main  decks,  so  that  these  are  now  free  from  contamination.  In  one  Chinese 
forecastle  a  number  of  live  fowls  were  discovered  living  in  common  with  the 
men.    Orders  were  at  once  given  to  have  them  removed  to  a  proper  coop  on  deck. 

One  case  occurred  on  a  foreign-owned  vessel  of  a  master  disputing  the 
right  of  the  Inspector  to  interfere  in  the  matter  of  nuisance  inspection,  as  he 
thought  liis  ship  was  outwith  Scottish  supervision.  It  was  explained  that  the 
Port  Local  Authority's  power  in  this  respect  was  stronger  than  even  the 
Merchant  Shipping  Act,  which  only  embraces  in  its  sections  the  right  to  deal 
with  "  any  British  ship,'^  while  the  Public  Health  (Scotland)  Act  gives  powers 
to  inspect  any  ships  except  war  vessels.  The  m^isances  found  on  board  were, 
However,  removed. 

Intimation  was  sent  to  other  Local  Authorities  in  25  cases,  advising  them 
of  filth  nuisances  and  structural  defects  found  here  which  could  not  be  remedied 
before  the  vessels  sailed  for  their  respective  ports. 


18 


The  following  return  shows  the  nationality  of  the  ships  which  arrived 
within  the  Glasgow  district  during  the  year  1905  as  compared  with  1904 :  — 


Nationality. 

Number  of  Vessels. 

1904. 

1905. 

Austrian, 

20 

20 

British, 

1,554 

1,569 

Belgian,      ...        ...  ..: 

1 

4 

Danish, 

21 

15 

Dutch, 

2 

5 

Eevntian,  ... 

1 

Finnish, 

1 

1 

French,       ...        ...        ...        . . .  , 

29 

41 

German, 

34 

27 

Greek, 

7 

4 

Hungarian,  ... 

1 

1 

Italian, 

34 

26 

Norwegian,  ... 

213 

175 

Roumanian,  

1 

Russian,      ...        ...  ... 

7 

2 

Spanish, 

62 

61 

Swedish, 

52 

61 

Total,   

2,038 

2,014 

At  the  Boarding  Station  at  Greenock,  2,014  vessels  were  either  hailed  or 
boarded,  and  partially  or  carefully  inspected.  Of  the  incoming  ships,  1,569 
were  British  and  445  foreign.  410  vessels  (of  which  315  were  British  and  95 
foreign)  were  notiiied  for  my  attention  at  the  various  harbours  on  arrival. 

Accumulations  of  manure  on  cattle-carrying  steamers  were  reported  to  the 
numbffr  of  137.  Almost  immediately  after  such  vessels  were  docked,  shore 
gangs  of  men  are  set  to  work  to  have  the  manure  removed  to  barges,  thence  to 
railway  trucks,  which  convey  it  to  the  country;  the  decks  and  cattle  stalls 
are  then  thoroughly  flushed,  after  which  the  compartments  for  the  cattle  are 
re-limewashed — a  process  which  is  efficiently  carried  out  in  every  instance. 

20  tons  1  cwt.  of  oranges,  ex  s.s.  "  Iberia,"  from  Valencia,  which  were  landed 
at  Prince's  Dock,  were  found  to  be  unsound,  and  were  sent  to  the  destructors 
in  Glasgow. 


19 


Seven  samples  of  ib  inkiug  water  were  taken  from  the  tanks  of  vessels  during 
1905  by  a  special  pnmp,  whicli  lias  been  designed  for  the  purpose  of  drawing 
from  the  bottom  of  the  tanks.  These  were  submitted  to  the  City  Analyst, 
Mr.  F.  W.  Harris.  The  results  of  his  analyses  are  given  in  the  Table 
annexed: — 


Analytical  Report  on  Samples  of  Drinking  Water  Collected  from  Ships. 
(All  results  expressed  in  grains  per  gallon.) 


No.  1. 

No.  2. 

No.  3. 

No.  4. 

No.  5. 

No.  6. 

No.  7. 

Appearance, 

Odour  at  212°  F.,  - 

iurbicl. 
Slight. 

Slightly 
J'urbid. 
None. 

teligntly 
Turbid. 
None. 

(Jlear. 
None. 

bligntiy 
Turbid. 
None. 

Turbid. 
None. 

lurDicl, 
None. 

Free  and  Saline  Ammonia, 
Albuminoid  Ammonia, 

Not 
Estimated. 
Do. 

Not 
Estimated. 
Do. 

Not 
Estimated. 
Do. 

0-003 
0-008 

0-002 
0-005 

Free. 
0-014 

Free. 
0-005 

Oxygen   absoi'bed    in  15 
minutes,  at  27°  C, 

Do. 

Do. 

Do. 

Not 
Estimated. 

Not 
Estimated. 

0  005 

0-005 

Oxygen  absorbed  in  4  hours, 
at  J  / 

Do. 

Do. 

Do 

0-104 

0-040 

0-076 

0  035 

Chlorine,  -       -       -  - 

75-6 

2-1 

13-3 

10 

1-2 

6-5 

6-5 

Suspended  Solds — 
Volatile  or  Organic, 

3-64 

4-51 

4-00 

None. 

1  -45  1 

Small 

Small 

Mineral,        -       _  - 

5-88 

3-99 

2-44 

Do. 

1-05  J 

Quantity. 

Quantity. 

Total, 

9-52 

8-50 

6-44 

Do. 

2-45 

Solids  in  Solution — 

Volatile  or  Organic.      -  f 

Mineral,        -       -       -  { 

Not 
Estimated. 

Not 
Estimated. 

Not 
Estimated. 

1  5-18 
J  5-39 

4-34 
4-62 

15-9 
41-7 

14-0 
39-9 

Total,  - 

10-57 

8-96 

57-6 

53-9 

Poisonous  Metals, 

None. 

None. 

None. 

None. 

None. 

None. 

None. 

From  these  data  Mr.  Harris  arrived  at  the  following  conclusions:  — 

"Sample  No.  1. — This  sample  was  labelled — Drinking  Water  from  ship  '  Umile 
Siegfried '  ( French ).  Tank  filled  at  Porro,  N.C.  The  quantity  of  the 
sample  submitted  was  totally  inequate  for  a  complete  analysis.  However, 
the  fact  that  the  sample  contained  75-6  grains  of  chlorine  per  gallon  (which 
is  equivalent  to  124-7  grains  of  sodium  chloride)  is  sufficient  to  indicate  that 
this  water,  as  represented  by  the  sample,  is  unfit  for  potable  purposes. 

"  Sample  No.  2. — This  sample  was  labelled — Sample  of  Water  from,  s.s.  '  Crown  of 
Navarre.'  Filled  at  Cape  Breton,  I^.S.,  20  days  ago  (October  17th,  1905). 
Owing  to  the  quantity  of  the  sample  supplied  being  relatively  small,  the  scope 
of  the  analysis  was  restricted,  and,  except  that  the  chlorine  figure  was  within 
the  limit  usually  found  in  drinking  water,  no  further  comment  can  be  made. 


Hood  suggested  for  use 
w/TH  Chip  Potato  boiling  Ranges. 


21 


FACTOEIES  AND  WOEKSHOPS. 

There  are  now  on  our  Eegisters  4,697  workshops  in  full  operation,  or  404 
in  excess  of  the  number  at  31st  December,  1904.  The  number  of  workshops 
measured  and  registered  during  1905,  along  with  other  information  regarding 
them,  will  be  found  in  Appendix  VI.,  and  in  the  immediately  succeeding 
Appendix  are  given  the  details  respecting  all  the  registered  workshops  now  in 
the  City. 

From  the  latter  it  will  be  seen  that  the  total  number  of  employees  in  these 
premises  under  the  constant  supervision  of  the  Department  is  33,215.  12,905 
are  men,  14,950  are  women,  5,350  are  young  persons  between  14  and  18  years 
of  age,  while  only  10  are  under  the  age  of  14. 

The  work  accomplished  in  the  workshops  and  in  the  homes  of  outworkers, 
with  respect  to  the  suppression  of  nuisances,  structural  and  otherwise,  will  be 
found  under  Heading  XI.  of  Appendix  II.,  and  need  not  be  reviewed  in  detail 
here.  Suffice  it  to  record  that  the  total  number  of  inspections  in  such  premises 
was  31,654. 

I  received  19  complaint  notices  under  Section  5  of  the  Factory  and  Work- 
shop Act,  1901,  from  His  Majesty's  Inspector  of  Factories — 9  in  the  Central 
District,  3  in  the  Eastern,  1  in  the  Southern,  4  in  the  Western,  and  2  in  the 
North-Western.    All  received  careful  attention. 

Under  "  Notice  No.  35,"  I  received  from  the  same  Inspector  266  notices 
with  regard  to  the  measuring  and  registration  of  workshops,  and  under  Section 
9  of  the  same  Act  he  forwarded  me  140  notices  with  respect  to  the  requirements 
of  the  Sanitary  Accommodation  Order,  1903.  In  91  cases  out  of  the  140  the 
needful  work  was  completed  in  terms  of  the  above  Order. 

Details  as  to  these  will  be  found  in  Appendix  VIII.  attached  to  this  Eeport. 

EESTAUEANTS. 

In  addition  to  the  above,  92  restaurants  were  measured  and  registered 
during  1905.  We  have  now  271  restaurants  on  the  Eegister  and  under  super- 
vision, employing  218  men,  742  women,  and  71  young  persons  under  IS  years 
of  age. 

A  considerable  number  of  complaints  continue  to  be  made  with  ref  erence  to 
the  ofiensive  odours  which  come  from  the  kitchens  of  the  restaurants  known  as 
Fried  Fish  Shops."  Investigation  has  shown  that,  for  the  most  part,  the 
odours  complained  of  are  due  to  the  occupiers  (mostly  foreigners)  frying  their 
fish  in  such  a  manner  that  the  oily  vapours  have  free  access  to  the  atmosphere 
of  the  kitchen  and  shop,  wherefrom  they  escape  to  the  adjacent  staircase  or  to 
the  dwellings  above  through  crevices  or  small  openings  in  the  ceiling  or  behind 
the  wall  linings.  In  order  to  prevent  this  form  of  nuisance,  I  have  caused  a 
sliding  hood  to  be  designed  over  the  pan  in  which  the  boiling  oil  or  fat  is 
contained.    (See  sketch  on  opposite  page.) 

The  new  Bj^e-laws  now  being  prepared  under  the  Glasgow  Building 
Eegulations  Act,  1900,  contain  a  clause  dealing  with  this  matter,  which  will 
render  compulsory  the  fitting  of  some  such  apparatus  over  the  boiling  or  frying 
stoves  in  restaurants  of  this  kind. 


22 


SALE  OF  FOOD  AND  DRUGS  ACTS. 

During  1905,  885  samples  of  food  and  drugs  were  procured  by  tlie  four 
Inspectors  set  aaprt  for  this  duty.  682  of  tkese  were  taken  under  the  Acts,  and 
submitted  to  Mr.  W.  F.  Harris,  tbe  City  Analyst.  The  following  tabular 
Statement  exhibits  the  results  of  their  operations  in  detail :  — 


1  ^ 

er  of  Sample 
'rocured. 

rH 

"3  rrt 

Article. 

er  Certifie 
enuine. 

er  Certifie 
Iterated. 

ber  in  whi 
oceedings 
1  institute( 

Amount 
Recovered 
in 
Fines 
and 

m 

'-^ 
'> 

O 

g 
1 

Numb 
Adu 

c  "  r 

Expenses. 

3 

£    s.  d. 

Sweet  Milk, 

178 

115 

63 

48 

101    5  4 

2 

Skimmed  Milk, 

16 

12 

4 

4 

8    0  0 

— 

Cream, ... 

4 

2 

2 

— 

— 

— 

Butter,... 

149 

140 

9 

7 

22  14  0 

— 

Margarine, 

18 

18 

— • 

18 

32    8  6 

1 

Cheese, 

12 

12 

— 

— 

— 

— 

Lai'd,  ... 

22 

22 

— 

— 

— 

Coffee,  ... 

42 

42 

— 

— 

— 

— 

,  Coffee  and  Chicory,  ... 

4 

4 

— 

— 

— 

Pepper, 

22 

22 

— 

— 

Mustard, 

7 

7 

— 

— 

Cream  of  Tartar, 

27 

26 

1 

— 

— 

Tartaric  Acid, ... 

1  D 

1  o 

3 

1 
i 

1    1  0 

— ■ 

Ground  Ginger, 

22 

22 

— 

— 

Crushed  Linseed, 

1.3 

13 

— 

— 

Ofl.'t.TYl  P?i  1 

LJ-LLl^CLJ.,                     ...                   ...  ... 

9 

9 

Tapioca, 

10 

10 

— 

Arrowroot, 

2 

2 

— 

Bailey, 

5 

5 

Preserves, 

4 

3 

1 

1 

1 

Camphorated  Oil, 

15 

14 

1 

1 

1  12  0 

Ohve  Oil,   

9 

9 

Cascara  Sagrada, 

17 

17 

Milk  of  Sulphur,   

9 

9 

Lime  Water,  ... 

9 

8 

1 

1 

1  12  0 

Extract  of  Malt,   

1 

1 

Brandy, 

20 

13 

7 

4 

12  12  0 

Whisky,   

12 

*12 

Rum,  ... 

8 

*7 

1 

Obstructing  Officer,  ... 

1 

3    3  0 

Totals,   

682 

589 

93 

86 

184    7  10 

4 

*  Certified  genuine  in  respect  to  alcoholic  atrength  only. 


Samples  procured  under  above  Acts,  ...        ...        ...        ...  682 

„  for  Private  Test  purposes,  ...        ...        ...  203 


Total  Samples  procured,       ...        ...        ...        ...  885 


Twenty-two  samples  of  so-called  Ciders  were  procured  and  submitted  for 
analysis  on  behalf  of  the  National  Fruit  and  Cider  Institute,  Long  Ashton, 
Bristol.  In  10  of  these  salicylic  acid  was  found,  and  in  1  the  estimated  quantity 
was  equal  to  45'62  grains  per  gallon.  The  full  details  of  analysis  have  not  yet 
been  furnished. 

It  is  to  be  regretted  that  the  Adulterated  Butter  Bill — in  a  somewhat 
amended  form — has  not  yet  found  a  place  on  the  Statute  Book,  which  would 
make  provision  for  dealing  with  the  makers  and  vendors  of  the  water-logged 
and  impoverished  commodities  presently  being  sold  with  impunity  as  butters. 

In  October,  I  caused,  under  the  instructions  of  the  Committee,  a  prosecu- 
tion to  be  taken  against  a  firm  of  grocers  for  selling  "  Apple  Black  Currant 
Jam,"  which  was  certified  by  the  Public  Analyst  to  contain  17"4  per  cent,  of 


23 


starcli  glucose,  wliicli  is  extraneous  to  sugar  and  fruit.  The  starcli  glucose 
syrup  used  by  certain  manufacturers  is  made,  for  the  most  part,  in  the  United 
States,  and  is  prepared  by  treating  maize  in  a  dilute  solution  of  sulpliuric  acid. 
It  bas  only  one-tliird  of  tbe  sweetening  power  of  true  sugar,  ^and  costs,  on  tbe 
average,  lis.  6d.  per  cwt.,  as  against  19s.  Gd.  per  cwt.,  tbe  price  of  sugar. 

After  trial,  tbe  Sberifi-Substitute  dismissed  tbe  case,  stating  tbat  be  was 
not  able  to  bold,  on  tbe  evidence  before  bim,  tbat  sucb  a  percentage  as  IT  "4  of 
glucose  was  inadmissible.  I  look  upon  tbis  decision  as  important,  as  I  am  con- 
vinced several  manufacturers  use  starcb  glucose  as  an  adulterant.  I  tberefore 
make  no  apology  for  giving  tbe  Sberiff's  decision  and  note  in  full. 

In  giving  judgment,  bis  Lordsbip  said — 

"  This  is  a  complaint  by  the  Inspector  for  the  City  and  Burgh  of  Glasgow  against 
grocers  for  selling  a  pot  of  jam  which  Avas  stated  not  to  be  of  the  nature,  substance, 
and  quality  of  the  article  demanded,  which  was  apple  black  currant  jam,  and  it  is 
stated  not  to  be  of  that  substance  and  quality  in  respect  that  it  contained  17'4  per 
cent,  of  glucose.  I  do  not  think  it  is  necessary  for  me  to  go  into  detail  as  to  the 
chemical  constitution  of  glucose,  but  I  may  say  it  is  admitted  that  it  is  a  harmless 
ingredient  and  a  nutritious  article  of  diet;  and,  speaking  roughly,  it  is  formed,  to  the 
extent  of  from  50  to  70  per  cent.,  of  dextrose  and  maltose,  which  are  sugar,  and  to 
the  remaining  extent  of  dextrine  and  water  —  dextrine  not  being  a  sugar,  but,  as  I 
ru:iderstand  it,  a  gummy,  starchy  substance,  which  is  without  sweetening  qualities. 

"  Now,  in  order  to  establish  this  complaint,  it  is,  of  course,  necessary  for  the  corn- 
plainer  to  satisfy  me  that  glucose  is  extraneous  to  jam,  and  his  averment  which  he 
undertook  to  prove  was  that  jam,  when  genuine,  consisted  altogether  of  fruit  and  sugars 
derived  from  cane  or  beet.  To  establish  this  (what  I  may  call  a  standard  of  jam), 
the  complainer  produced  two  classes  of  witnesses — the  evidence  of  skilled  witnesses, 
such  as  Mr.  Harris  and  Dr.  Clark,  and  the  evidence  of  manufacturers  in  the  jam  trade. 
As  regards  the  first  class  of  evidence  (that  of  the  chemists),  it  would,  of  course,  have 
been  of  very  great  value  if  it  had  been  directed  upon  the  point  of  what  actually  con- 
stitutes jam,  when  one  regards  jam  as  the  article  sold  in  the  market. 

"  After  careful  consideration  of  the  evidence  of  these  gentlemen,  however,  I  am 
unable  to  see  that  it  is  directed  to  that  point  at  all.  It  seems  to  me  that  these  gentle- 
men,-in  giving  their  evidence,  had  been  giving  it  very  much  as  to  what  jam  ought 
to  be  - —  not,  as  matter  of  fact,  what  it  is.  Now,  it  seems  to  me  that  the  question  I 
have  to  consider  in  dealing  with  this  complaint  of  contravening  the  Sale  of  Food  and 
Drugs  Act  is — What  is  jam,  as  sold  in  the  market  and  commonly  manufactured  for 
that  purpose?  I  think  one  must  have  regard  to  the  facts  as  they  are,  and,  as  there  is 
no  legal  standard,  one  must  arrive  at  an  idea  of  what  jam  is  by  finding  what  has,  as 
a  matter  of  fact,  been  sold  for  a  considerable  period  under  that  name.  In  other  words, 
the  question  is,  Avhat  a  purchaser  has  a  reasonable  right  to  expect  to  get  when  he  asks 
for  jam  in  a  shop. 

"  The  question  cannot  be  answered  by  considering  the  opinion  of  eminent  analytical 
chemists  as  to  what  they  think  jam  ought  to  consist  of,  but  by  regard  to  the  practice 
of  those  who  manufacture  and  sell  jam.  Now,  as  to  the  evidence  of  manufacturers, 
there  were  three  manufacturers  examined  for  the  prosecution,  and  the  result  of  their 
evidence  may  be  said  to  be  that  they  admit  that  the  use  of  glucose  is  extremely  common 
in  the  manufacure  of  jam,  and,  further,  they  could  not  say  there  was  any  standard  of 
jam,  or  that  the  addition  of  a  percentage  of  glucose  rendered  the  article  not  jam. 
Now,  it  seems  to  me  that,  even  on  that  evidence,  apart  from  the  evidence  for  the 
defence,  it  is  impossible  to  find  that  the  complainers  have  established  what  is  essential 
to  the  success  of  the  complaint — that  jam,  when  genuine,  consists  of  fruit  and  sugars 
derived  from  cane  or  beet.  The  evidence  of  the  manufacturers  for  the  defence  was  to 
the  effect  that  the  use  of  glucose  was  so  common  in  the  making  of  jam  as  to  be  almost 
luiiversal,  and  that  it  has  been  in  use  for  a  number  of  years  past,  one  of  the  Avitnesses 
putting  it  down  at  twenty-five  or  thirty  years,  and  that,  as  to  the  amount,  the  recipes 
of  various  manufacturers  varied.  In  some  cases,  as  appears  from  the  evidence,  glucose 
is  not  used  at  all,  the  fruits  not  requiring  it,  but  in  other  cases  glucose  is  said  to  be 
very  useful,  not  only  because  it  is  cheaper,  but  because  it  Avas  admitted  that  it  made 
it  easier  to  manufacture  the  jam,  while  at  the  same  time  the  jam  would  not  granulate 
or  crystallise  so  readily.  If  these  are  the  facts  —  that  for  a  great  numljer  of  years, 
amounting  to  tAventy-five  or  thirty,  jam  made  Avith  glucose  along  AA-ith  sugars  from 


24 


cane  or  beet  has  been  commonly  sold  in  the  market — I  think  it  is  quite  impossible  for 
me  to  hold  that  there  is  a  standard  for  genuine  jam  which  excludes  glucose  as  extraneous 
matter,  and  therefore  I  have  come  to  the  conclusion  that  the  oomplainer  has  failed  to 
establish  this  essential  averment  in  the  complaint — that  genuine  jam  consists  altogether 
of  fruit  with  cane  or  beet  sugar. 

"  It  may  be  remarked,  in  passing,  that  such  a  standard  would  exclude  other  sugars, 
such  as  sorghum  or  maple,  but,  as  far  as  the  market  here  is  concerned,  I  do  not  think 
these  sugars  enter  into  the  constitution  of  jam. 

'■'  For  these  reasons,  I  come  to  the  conclusion  that  the  jorosecution  fails.  In  these 
circumstances,  it  is  not  necessary  for  me  to  deal  with  another  point  raised — whether 
the  small  label  on  the  top  of  the  pot,  intimating  that  the  contents  consisted  of  fruit 
and  sugar  mixed  with  other  harmless  ingredients,  would  protect  the  respondents.  I 
do  not  need  to  go  into  that,  because  the  whole  complaint  fails. 

"  I  may  say,  however,  that  towards  the  end  of  the  case  the  complainer  adopted  a 
rather  different  ground,  and  attempted  to  show  that  the  percentage  of  glucose  in  this 
particular  pot  of  jam  was  excessive.  I  do  not  think,  of  course,  the  complainer  could 
succeed  under  this  complaint  on  any  such  ground,  because  he  had  undertaken  to  prove 
that  genuine  jam  consisted  of  fruit  and  sugars  derived  from  cane  or  beet,  to  the 
exclusion  of  glucose,  and  he  has  not  given  notice  to  the  respondents  that  he  would 
raise  the  question  as  to  what  was  a  permissible  percentage  of  glucose.  In  these  circum- 
stances it  would  be  very  unfair  for  me  to  deal  with  the  case  on  that  footing.  Apart 
from  that,  as  I  have  said,  the  recipes  of  various  manufacturers  differ,  and  I  am  not 
able  to  hold,  on  the  evidence  before  me,  that  such  a  percentage  as  17"4  of  glucose  would 
be  inadmissible.  It  is  to  be  remembered,  as  I  pointed  out,  that  glucose  is  a  harmless 
substance,  and  that  more  than  50  per  cent,  is  sugar.  I  therefore  assoilzie  the 
respondents,  and  under  the  Sale  of  Food  and  Drugs  Act  cannot  give  expenses." 

Mr.  M'lntyre,  for  the  complainer,  intimated  tlaat  the  prosecution  might 
ask  his  Lordship  to  state  a  case  for  appeal  to  the  High  Court. 

On  careful  consideration,  it  was  considered  inexpedient  to  proceed  vs^ith  an 
appeal,  but,  pending  further  legislation,  the  public  Avould  be  well  advised  if 
they  took  care  to  ascertain,  when  they  purchase  jams  or  jellies,  that  it  is  the 
genuine  article,  and  guaranteed  "  free  from  starch  glucose  or  other  preserva- 
tives than  pure  cane  or  beetroot  sugar."  It  should  be  remembered  that  starch 
glucose  contains  about  30  per  cent,  of  a  substance  known  as  dextrine  or  British 
gum,  which  is  quite  foreign  to  fruit  of  all  kinds,  and  is  unknown  in  real  sugar. 

It  came  to  my  knowledge  in  July  that  children's  coloured  toys  were  being 
sold  in  a  certain  warehouse  which  were  of  a  suspicious  character.  Seven  toys 
were  purchased,  and  submitted  to  the  City  Analyst,  Mr.  Harris.  He  found 
that  two  of  the  samples  contained  lead,  and,  on  my  communicating  with  the 
vendor,  he  at  once  stopped  their  sale,  and  promised  to  send  them  back  to  the 
manufacturer.  The  articles  in  question  consisted  of  coloured  birds,  dogs,  men, 
women,  and  clay  models  of  policemen.  Most  of  them  had  whistles  attached, 
which  made  them  attractive  to  children. 

FISH  A'^B  GAME  INSPECTIOI^T. 

The  following  are  the  details  of  the  work  done  in  the  Corporation  Fish 
Market  by  the  special  Inspector  attached  to  this  department :  — 

596  separate  parcels  were  found  unfit  for  food,  and  were  destroyed  by  the 
various  consignees,  at  the  instance  of  the  Inspector :  — 

Fresh  Fish  Destroyed. 

Lbs. 

Herring,...        ...        ...        ...        ...        ...        ...  13,956 

Haddock,                                                ■   4,288 

Whiting,    3,254 

Cod,    4,210 

Codling,   4,400 

Ling,    340 

Mackerel,    470 


Carry  forward, 


30,918 


25 


Brought  forward, 


Bream,    . . . 
Berglot,  . . . 
Sparling, . . . 
Grilse, 
Shark, 
Halibut,  ... 
Whitches, 
Black  Soles, 
Lemon  Soles, 
Roes, 

Various,  ... 
Cray, 
Crabs, 
Shrimps,  ... 
Eschallops, 
Cockles,  ... 
Mussels,  ... 


Total, 


Lbs. 
30,918 
620 
400 
10 
30 
500 
156 
320 
36 
14 
28 
160 
200 
130 
112 
210 
726 
448 

35,018 


Cured  Fish  Destroyed. 


Herring, 

Haddock, 
Whiting, 
Saithe, 
Fillets,  .. 
Prawn, 


Lbs. 
270 
1,596 
546 
560 
854 
28 


Total, 


3,854 


Game,  Poultry,  and  Rabbits  Destroyed. 


Head. 

Black  Cock,       ...        ...        ...        ...        ..         ...  66 

Hazel  Hen,     260 

Partridge,          ...        ...        ...        ...        ...        ...  2 

Pigeon  (Wood),  ...        ...        ...        ...        ...        ...  23 

Turkey,  ...        ...        ...        ...        ...        ...        ...  55 

Fowl,    82 

Duck,     ...        ...        ...        ...        ...        ...        ...  6 

Rabbit,   507 


Total,    1,001 


This  sliows  a  decrease  of  11,118  lbs.  of  fresli  fish  and  9,742  lbs.  of  cured 
fish  destroyed,  as  compared  with  last  year,  and  an  increase  of  493  head  of  game, 
poultry,  and  rabbits.  In  all,  897,518  parcels  were  inspected,  a  decrease  of 
73,120  as  compared  with  1904. 

1,988  visits  were  also  paid  to  the  fish  restaurants  and  565  to  the  retail  fish 
shops  throughout  the  City,  and  1,159  inspections  were  made  of  fish  hawkers' 
carts  and  barrows.  31  fish  restaurants,  1  retail  fish  shop,  and  1  poulterer's 
shop  were  found  to  be  in  a  filthy  condition,  and  the  owners  notified.  In  each 
case  the  necessary  cleansing  was  duly  carried  out. 

Eight  cases  of  illegal  trafficking  in  poached  salmon  were  reported  to  the 
Fishmongers'  Company  of  London,  resulting  in  seven  convictions  being 
obtained.    One  case  was  found  not  proven. 

Many  complaints  were  received  with  regard  to  fish  of  the  salmon  kind, 
coming  from  the  Clyde  and  Leven  Rivers  (Dumbartonshire),  being  tainted  with 
pollution,  and  unfit  for  food. 

A  small  office  has  been  erected  in  the  Fish  Market  gallery  for  the  use  of 
the  Fish  Inspector. 


26 


DAIRY  OEDERS  AJ^D  CATTLE-SHEDS  ACT. 

At  December  31st  there  were  1,254  milk  purveyors  and  499  ice-cream 
dealers  in  Glasgow,  as  compared  with.  1,229  and  449  respectively  in  1904.  Iso 
breach  of  the  Regulations  was  of  such  a  character  as  to  necessitate  a  prosecution 
in  Court. 

There  was  a  reduction  of  two  City  byres  during  the  year,  there  being  now 
81,  in  which  842  cows  are  stalled.  As  time  goes  on,  the  number  of  City-stalled 
cows  steadily  diminishes.  In  1902  there  were  967;  in  1903,  939;  and  in 
1904,  865. 

Model  Regulations  anent  Dairies,  Cow-sheds,  and  Milk-shops  were  issued 
by  the  Local  Grovernment  Board  during  1905,  which  contain  several  new  pro- 
visions. It  is  my  intention,  when  time  permits,  in  conjunction  with  the  Medical 
Officer  and  the  Veterinary  Surgeon,  to  present  to  the  Health  Committee  several 
recommendations  with  a  view  to  the  amendment  of  our  present  Regulations,  so 
as  to  bring  them  into  line  with  the  Local  Government  Board's  proposals.  Some 
steps  should  also  be  taken  soon  to  give  practical  effect  to  the  powers  contained 
in  Sections  24  and  25  of  the  Glasgow  Police  (Amendment)  Act,  by  which  milk 
suspected  to  be  conveying  disease  to  the  public  may  be  stopped  at  the  source 
of  supply,  wherever  situated,  and  the  affected  cow  or  cows  so  dealt  with  as  to 
prevent  their  milk  being  sold  within  the  City. 

In  the  recently  annexed  burgh  of  Kinning  Park  there  are  15  milk  pur- 
veyors and  2  ice-cream  vendors.  In  the  premises  of  five  of  them  it  was  needful 
to  have  structural  alterations  carried  out.  In  one  byre  for  12  cows  extensive 
alterations  were  made  so  as  to  improve  the  drainage,  ventilation,  and  lighting, 
and  a  milk  scullery  was  added  to  secure  the  proper  washing  of  the  milk  utensils. 


SHOP  HOURS  ACTS,  1892-1895. 

4,396  primary  inspections  were  made  in  shops  by  the  special  officer  under 
the  above  Acts.  In  one  case  a  firm  of  bakers  was  found  employing  young 
persons  in  six  of  their  shops  in  contravention  of  Sections  3  and  4  of  the  Act. 
They  pled  guilty  when  brought  before  the  Sheriff,  and  were  fined  10s.  for  each 
offence,  with  17s.  6d.  in  addition  for  Court  expenses.  Three  other  shopkeepers 
were  found  contravening  the  Acts.  Two  of  them  were  prosecuted — one  being 
fined  in  20s.,  with  19s.  6d.  for  expenses,  and  the  other  got  off  on  the  girl  deny- 
ing in  Court  what  she  had  previously  told  the  Inspector  with  regard  to  her 
working  hours. 

522  Shop  Hours  !N"otice  Cards  were  issued  from  the  office  to  shopkeepers, 
39  of  these  being  charged  threepence  for  them,  in  respect  that  cards  had  been 
previously  supplied,  and  lost  through  carelessness. 

The  following  short  statement  shows  the  details  of  the  work  done  under 
these  Acts  :  — 


First  Inspections,         ...        ...        ...        ...  ...  ...  4,396 

Oifenders  found  contravening  Section  3,  ...  ...  1 

4  5 

,,                                                                    ,,1:,  ...  ...  t> 

Prosecutions  (against  one  firm),  ...        ...  ...  ...  6 

Secondary  Inspections,...        ...        ...        ...  ...  ...  8,005 

Offenders  found  contravening  Section  3,  ...  ...  2 

4  1 

))                                             ))                                     J)               ^)  ...  ...  X 

Prosecutions,        ...        ...        ...        ...  ...  ...  2 

Heinspeciions  to  former  Offenders,       ...        ...  ...  ...  85 

Found  complying;           ...        ...        ...  ...  ...  All 

Shop  Hours  Cards  given  out,  ...        ...        ...  ...  ...  522 

,,         „         paid  for  (3d.  each),         ...  ...  ...  39 

Fines  imposed  and  recovered  (,£4,  with  £1  I7s.  costs),  ...  £5  17s. 


DRAWING  SHOWING  CATCH-PIT  AND  BAFFLE  WALLS  IN  BOILER 
FLUE,  WITH  WATER-SPRAY  IN  CHIMNEY,  FOR  THE  RETENTION 
OF  SMALL  PARTICLES  OF  ASH  AND  SMUTS  FROM  FORCED 
DRAUGHT  FURNACES. 


5cA LE.  i"-  I  Toot 

Sanitary  Chambers,  | 
Glasgow,  March,  1906.  I 


I 


I 

i 

I 
I 

i 

I 

I 
I 


1 

I 


i 
1 

i 

I 

I 

i 
I 


j 

S 

■i 

j 

t 

I 

I 
1 

\ 

I 


27 


SEATS  FOR  SHOP  ASSISTANTS  ACT,  1899. 

The  following  was  the  work  done  under  tlie  above  Act:  — 

First  Inspections, 
Found  complying, 

,,     without  Seats, 
Provided  Seats,  ... 
Prosecuted, 

No  prosecutions  were  necessary,  as  shopkeepers,  on  being  warned,  at  once 
provided  the  seats  required ;  but  the  Inspector  reports  that  in  several  instances 
the  mere  proAasion  of  seats  does  not  give  any  real  easement  to  the  girls,  as  they 
are  not  permitted  to  use  them,  except  at  the  risk  of  dismissal,  such  masters 
alleging  that  they  "  have  no  use  for  girls  who  have  time  to  sit." 


1,957 
17 
17 
0 


SMOKE  ABATEMENT. 

Steady  progress  continues  to  be  made  in  the  work  of  reducing  the  daily  issue 
of  smoke  from  factory  chimneys.  14,406  observations  of  svich  chimneys  were 
made  during  the  year  by  the  four  Smoke  Inspectors,  who  also  made  1,395 
careful  inspections  of  boiler  and  other  furnaces  Avhich  were  recognised  as 
regular  smoke  producers.  As  will  be  seen,  on  referring  to  Part  XII.  of 
Appendix  II.,  127  prosecutions  were  taken  against  offenders,  resulting  in  124 
convictions,  and  fines  were  imposed  amounting  to  £111  lis.  6d. 

In  98  of  these  cases  the  excessive  smoke  production  was  due  to  carelessness 
or  want  of  skill  on  the  part  of  the  firemen,  while  in  the  remaining  2G  cases, 
although  the  element  of  careless  firing  played  a  certain  part,  want  of  chimney 
draught,  insufficient  boiler  power,  defective  flues,  or  other  structural  causes 
were  mainly  responsible  for  the  nuisance  produced.  15  cases  which  were 
departed  from  were  so  dealt  with  after  hearing  representations  on  the  part  of 
the  various  offenders  to  the  effect  that  the  excessive  smoke  made  was  caused  by 
some  accident  to  the  furnace  or  boilers,  or  to  the  unavoidable  absence  of  the 
regular  fireman. 

As  indicated  above,  improvements  on  furnaces  continue  to  be  made  at  our 
instance,  details  of  which  will  be  found  in  the  Appendix  referred  to. 

A  special  complaint  came  to  me,  through  a.  member  of  the  Committee,  of 
two  chimney  stalks  in  the  City  from  which  an  abnormal  discharge  was  con- 
tinually being  made  of  small  particles  of  ashes,  which  descended  like  black 
hail  all  round  the  immediate  neighbourhood  of  the  chimineys.  As  this  peculiar 
discharge  was  not  of  the  nature  of  smoke,  I  had  to  take  special  means  to  combat 
it.  Eive  dust  gauges  were  set  down  on  the  roofs  of  adjacent  buildings  all  round 
the  chimneys  in  question,  where  they  were  left  for  fourteen  days.  The  contents 
were  then  placed  in  the  hands  of  the  Corporation  Chemist,  who  reported  on  the 
28th  of  August  that  on  each  square  foot  of  surface  there  had  fallen  from  5  to 
94  grains  of  the  grit  and  dust  complained  of.  On  a  second  test  being  made, 
during  fifteen  days  in  October,  the  amount  which  had  fallen  into  the  five  boxes 
was  found  to  have  increased  in  two  of  them  to  182  and  254  grains  per 
square  foot. 

As  this  discharge  was  being  caused  by  the  firm  in  question  burning  a  low- 
class  fuel  under  forced  draught  in  closed  ashpits,  representations  were  made  to 
the  firm,  who  at  once  set  about  making  certain